Repurposed pharmacological agents for the potential treatment of COVID-19: a literature review

Abstract Background The COVID-19 pandemic has affected the world extraordinarily. This disease has a potential to cause a significantly severe course of disease leading to respiratory complications, multiple organ failure and possibly death. In the fight against this pandemic-causing disease, medica...

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Autores principales:	Alina Kröker, Madara Tirzīte
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	SARS-CoV-2 COVID-19 Chloroquine Hydroxychloroquine Azithromycin Lopinavir/ritonavir Diseases of the respiratory system RC705-779
Acceso en línea:	https://doaj.org/article/d17c13a6ba824371b7955bb5a6505def
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spelling	oai:doaj.org-article:d17c13a6ba824371b7955bb5a6505def2021-11-28T12:29:14ZRepurposed pharmacological agents for the potential treatment of COVID-19: a literature review10.1186/s12931-021-01885-81465-993Xhttps://doaj.org/article/d17c13a6ba824371b7955bb5a6505def2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12931-021-01885-8https://doaj.org/toc/1465-993XAbstract Background The COVID-19 pandemic has affected the world extraordinarily. This disease has a potential to cause a significantly severe course of disease leading to respiratory complications, multiple organ failure and possibly death. In the fight against this pandemic-causing disease, medical professionals around the world are searching for pharmacological agents that could treat and prevent disease progression and mortality. To speed the search of promising treatment options, already existing pharmacological agents are repurposed for the potential treatment of COVID-19 and tested in clinical trials. The aim of this literature review is to investigate the efficacy and safety of repurposed pharmacological agents for the treatment of COVID-19 at different pathophysiologic stages of the disease. For this literature review, online-databases PubMed and Google Scholar were utilised. Keywords “COVID-19”, “SARS-CoV-2”, “pathogenesis”, “drug targets”, “pharmacological treatment”, “cytokine storm”, “coagulopathy” and individual drug names were used. Scientific articles, including reviews, clinical trials, and observational cohorts, were collected and analysed. Furthermore, these articles were examined for references to find more clinical trials testing for the potential treatment of COVID-19. In total, 97 references were used to conduct this research paper. Results The most beneficial pharmacological agent for the treatment of COVID-19 are corticosteroids, especially dexamethasone, for the treatment of mechanically ventilated COVID-19 patients. Other promising agents are remdesivir for the treatment of patients with COVID-19 pneumonia requiring minimal supplemental oxygen therapy, and IL-6 receptor antagonist monoclonal antibodies in severe COVID-19. Lopinavir/ritonavir, as well as chloroquine or hydroxychloroquine with or without azithromycin demonstrate the least efficacy in the treatment of COVID-19. The clinical benefits of the treatment of a COVID-19-specific coagulopathy with increased dosing of anticoagulation need further research and confirmation of randomised controlled trials. Conclusion The search for pharmacological treatment of COVID-19 has elicited great controversy. Whereas drugs like chloroquine, hydroxychloroquine, and lopinavir/ritonavir have not shown proven benefit, the agents remdesivir and dexamethasone are recommended for clinical use for the treatment of COVID-19. Further randomised trials for other pharmacological treatment strategies are awaited.Alina KrökerMadara TirzīteBMCarticleSARS-CoV-2COVID-19ChloroquineHydroxychloroquineAzithromycinLopinavir/ritonavirDiseases of the respiratory systemRC705-779ENRespiratory Research, Vol 22, Iss 1, Pp 1-27 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	SARS-CoV-2 COVID-19 Chloroquine Hydroxychloroquine Azithromycin Lopinavir/ritonavir Diseases of the respiratory system RC705-779
spellingShingle	SARS-CoV-2 COVID-19 Chloroquine Hydroxychloroquine Azithromycin Lopinavir/ritonavir Diseases of the respiratory system RC705-779 Alina Kröker Madara Tirzīte Repurposed pharmacological agents for the potential treatment of COVID-19: a literature review
description	Abstract Background The COVID-19 pandemic has affected the world extraordinarily. This disease has a potential to cause a significantly severe course of disease leading to respiratory complications, multiple organ failure and possibly death. In the fight against this pandemic-causing disease, medical professionals around the world are searching for pharmacological agents that could treat and prevent disease progression and mortality. To speed the search of promising treatment options, already existing pharmacological agents are repurposed for the potential treatment of COVID-19 and tested in clinical trials. The aim of this literature review is to investigate the efficacy and safety of repurposed pharmacological agents for the treatment of COVID-19 at different pathophysiologic stages of the disease. For this literature review, online-databases PubMed and Google Scholar were utilised. Keywords “COVID-19”, “SARS-CoV-2”, “pathogenesis”, “drug targets”, “pharmacological treatment”, “cytokine storm”, “coagulopathy” and individual drug names were used. Scientific articles, including reviews, clinical trials, and observational cohorts, were collected and analysed. Furthermore, these articles were examined for references to find more clinical trials testing for the potential treatment of COVID-19. In total, 97 references were used to conduct this research paper. Results The most beneficial pharmacological agent for the treatment of COVID-19 are corticosteroids, especially dexamethasone, for the treatment of mechanically ventilated COVID-19 patients. Other promising agents are remdesivir for the treatment of patients with COVID-19 pneumonia requiring minimal supplemental oxygen therapy, and IL-6 receptor antagonist monoclonal antibodies in severe COVID-19. Lopinavir/ritonavir, as well as chloroquine or hydroxychloroquine with or without azithromycin demonstrate the least efficacy in the treatment of COVID-19. The clinical benefits of the treatment of a COVID-19-specific coagulopathy with increased dosing of anticoagulation need further research and confirmation of randomised controlled trials. Conclusion The search for pharmacological treatment of COVID-19 has elicited great controversy. Whereas drugs like chloroquine, hydroxychloroquine, and lopinavir/ritonavir have not shown proven benefit, the agents remdesivir and dexamethasone are recommended for clinical use for the treatment of COVID-19. Further randomised trials for other pharmacological treatment strategies are awaited.
format	article
author	Alina Kröker Madara Tirzīte
author_facet	Alina Kröker Madara Tirzīte
author_sort	Alina Kröker
title	Repurposed pharmacological agents for the potential treatment of COVID-19: a literature review
title_short	Repurposed pharmacological agents for the potential treatment of COVID-19: a literature review
title_full	Repurposed pharmacological agents for the potential treatment of COVID-19: a literature review
title_fullStr	Repurposed pharmacological agents for the potential treatment of COVID-19: a literature review
title_full_unstemmed	Repurposed pharmacological agents for the potential treatment of COVID-19: a literature review
title_sort	repurposed pharmacological agents for the potential treatment of covid-19: a literature review
publisher	BMC
publishDate	2021
url	https://doaj.org/article/d17c13a6ba824371b7955bb5a6505def
work_keys_str_mv	AT alinakroker repurposedpharmacologicalagentsforthepotentialtreatmentofcovid19aliteraturereview AT madaratirzite repurposedpharmacologicalagentsforthepotentialtreatmentofcovid19aliteraturereview
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Repurposed pharmacological agents for the potential treatment of COVID-19: a literature review

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