Medical management of COVID-19: treatment options under consideration

Abstract

An outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in Wuhan, China in December 2019. Despite the worsening trends of COVID-19, currently, no drugs are validated to have significant efficacy in the clinical treatment of COVID-19. The drugs currently being explored are hydroxychloroquine, antivirals like remdesivir, favipiravir alone or in combination, antibiotics like azithromycin and doxycycline. Low dose corticosteroids, either oral or intravenous, have also shown promising results in reducing mortality. On the other hand, Immunomodulators and biologics are found to be very effective in some cases. Autopsy finding of patients with COVID-19 shows the evidence of endothelial damage and formation of microthrombi with multiorgan involvement and, ultimately, multiorgan failure; hence anticoagulants also seem to have a definite role in preventing microvasculature clogging and multiorgan dysfunction. Pulmonary vasodilators acting via the cGMP/cAMP pathway may also prove to be beneficial in reducing airway hyper inflammation. In this review, authors have attempted to summate the potential drugs therapies with emphasis on convalescent plasma, and at last, the most awaited thing of this pandemic, COVID-19 vaccine.