COVID-19: Medication therapy: Difference between revisions
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***A small prospective, open label study conducted in China has shown promise in symptom reduction for moderatly ill patients with COVID-19 and has not yet been peer reviewed <ref>https://www.medrxiv.org/content/10.1101/2020.03.17.20037432v3</ref>
***A small prospective, open label study conducted in China has shown promise in symptom reduction for moderatly ill patients with COVID-19 and has not yet been peer reviewed <ref>https://www.medrxiv.org/content/10.1101/2020.03.17.20037432v3</ref>
**[[Ribavirin]]
**[[Ribavirin]]
***Has been used in patients with [[MERS]] with inconclusive results.<ref>Arabi YM, et al. Ribavirin and Interferon Therapy for Critically Ill Patients With Middle East Respiratory Syndrome: A Multicenter
Observational Study. Clin Infect Dis. 2019 Jun 25. https://www.ncbi.nlm.nih.gov/pubmed/31925415.</ref>
***Small trials in China and North America have failed to establish a therapeutic benefit of Ribavirin. <ref>Devaux CA1, Rolain JM2, Colson P2, Raoult D2. New insights on the antiviral effects of chloroquine against coronavirus: what to expect for COVID-19?. Int J Antimicrob Agents. 2020 Mar 12:105938. doi: 10.1016/j.ijantimicag.2020.105938.</ref>
*[[Chloroquine]]/[[Hydroxychloroquine]]
*[[Chloroquine]]/[[Hydroxychloroquine]]
*[[Immunomodulators]]
*[[Immunomodulators]]
**[[Interferon]]
**[[Tocilizumab]]
*[[IVIG]]
*[[IVIG]]
*Convalescent Plasma
*Convalescent Plasma

Revision as of 18:24, 12 April 2020

Investigational Therapies

Treatment for those infected with SARS-CoV-2 focuses on supportive care which includes symptomatic management, hand hygiene and social distancing. While many treatments are under investigation there is no proven efficacy of any drug for human as of April 8th 2020.[1].Medication management at this time is targeted towards those requiring inpatient admission.

  • Symptomatic management
  • Antivirals
    • Lopinavir/Ritonavir
      • Known in the U.S as Kaletra, this HIV medication has been widely used in China to treat COVID patients.[2].
      • An RCT with 199 confirmed COVID-19 positive patients concluded that there was no benefit to treating hospitalized patients with Lopinavir/Ritonavir versus supportive care.[3]
    • Remdesivir
      • Previously used to treat Ebola[4] this medication inhibits viral RNA polymerase and has shown some promisinng invitro activity against SARS-CoV-2.
      • A recent small study among 53 patients with severe symptoms from COVID-19 were given Remdesivir for compassionate use. 68% percent of patients showed some clinical improvement.[5]
      • A large NIH funded trial is currently underway to assess the efficacy of this medication [6]
      • Consider using in hospitalized patients with severe symptoms and significant Oxygen requirements
      • Contact Gilead directly for use: compassionateaccess@gilead.com
    • Oseltamivir
      • Several small trials have not shown any benefit in patients with COVID-19. [7]
    • Baloxavir marboxil
      • Several clinical trials are underway however there is no evidence at this time for the efficacy of Baloxavir marboxil in treating COVID-19
    • Favipiravir
      • A small, open label, non-randomized trial in China has shown promising results and has not been peer reviewed.[8]
      • A small prospective, open label study conducted in China has shown promise in symptom reduction for moderatly ill patients with COVID-19 and has not yet been peer reviewed [9]
    • Ribavirin
      • Has been used in patients with MERS with inconclusive results.[10]
      • Small trials in China and North America have failed to establish a therapeutic benefit of Ribavirin. [11]


Contraindicated Therapies

See Also

COVID-19 Pages

References

  1. ↑ Auwaerter. Johns Hopkins Antibiotic guide. Coronavirus COVID-19. April 8 2020
  2. ↑ https://www.reuters.com/article/us-health-coronavirus-china-wuhan-hospit/key-china-coronavirus-hospital-says-hiv-drug-beneficial-to-patients-idUSKCN21R1LX
  3. ↑ Cao, B., Wang, Y., Wen, D., Liu, W., Wang, J., Fan, G., ... & Li, X. (2020). A trial of lopinavir–ritonavir in adults hospitalized with severe Covid-19. New England Journal of Medicine.
  4. ↑ Auwaerter. Johns Hopkins Antibiotic guide. Coronavirus COVID-19. April 8 2020
  5. ↑ Grein, J., Ohmagari, N.,...Oda, R (2020). Compassionate Use of Remdesivir for Patients with Severe COVID-19. New England Journal of Medicine.
  6. ↑ https://clinicaltrials.gov/ct2/show/NCT04280705
  7. ↑ Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. E-pub Date: aheadofprint February 2020. DOI # 10.1001/jama.2020.1585 . https://www.ncbi.nlm.nih.gov/pubmed/32031570
  8. ↑ https://www.jwatch.org/na51293/2020/04/09/favipiravir-potential-antiviral-covid-19
  9. ↑ https://www.medrxiv.org/content/10.1101/2020.03.17.20037432v3
  10. ↑ Arabi YM, et al. Ribavirin and Interferon Therapy for Critically Ill Patients With Middle East Respiratory Syndrome: A Multicenter Observational Study. Clin Infect Dis. 2019 Jun 25. https://www.ncbi.nlm.nih.gov/pubmed/31925415.
  11. ↑ Devaux CA1, Rolain JM2, Colson P2, Raoult D2. New insights on the antiviral effects of chloroquine against coronavirus: what to expect for COVID-19?. Int J Antimicrob Agents. 2020 Mar 12:105938. doi: 10.1016/j.ijantimicag.2020.105938.
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