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In this literature review, the authors included studies, reports, and articles about pharmacologic treatments for COVID-19 published through March 25, 2020. They also identified 109 active pharmacologic trials for the treatment of COVID-19 as of April 2, 2020. Included in this review is a discussion of chloroquine, hydroxychloroquine, lopinavir/ ritonavir, ribavirin, remdesivir, corticosteroids, and immunomodulatory agents.
The authors identify many limitations, including the fact that much of the published data are from observational studies or small clinical trials, and that this review focused only on adult patients. To date, no therapies have been shown to be effective, and high-quality evidence is urgently needed.
This abstract is available on the publisher's site.
The pandemic of coronavirus disease 2019 (COVID-19) caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) presents an unprecedented challenge to identify effective drugs for prevention and treatment. Given the rapid pace of scientific discovery and clinical data generated by the large number of people rapidly infected by SARS-CoV-2, clinicians need accurate evidence regarding effective medical treatments for this infection.
No proven effective therapies for this virus currently exist. The rapidly expanding knowledge regarding SARS-CoV-2 virology provides a significant number of potential drug targets. The most promising therapy is remdesivir. Remdesivir has potent in vitro activity against SARS-CoV-2, but it is not US Food and Drug Administration approved and currently is being tested in ongoing randomized trials. Oseltamivir has not been shown to have efficacy, and corticosteroids are currently not recommended. Current clinical evidence does not support stopping angiotensin-converting enzyme inhibitors or angiotensin receptor blockers in patients with COVID-19.
Conclusions and Relevance
The COVID-19 pandemic represents the greatest global public health crisis of this generation and, potentially, since the pandemic influenza outbreak of 1918. The speed and volume of clinical trials launched to investigate potential therapies for COVID-19 highlight both the need and capability to produce high-quality evidence even in the middle of a pandemic. No therapies have been shown effective to date.