COVID-19 Treatment Options and Their Mechanism of Action up to Now: An Overview of Clinical Trials

Abstract

Novel coronavirus causes the outbreak of COVID-19. There is still no verified treatment regimen against this novel virus; however, different drugs and compounds have been tested against it. Ample proposals have led to a good understanding of pathogenesis and drug efficacy against the novel virus disease. Excess systemic inflammation, which is described as cytokine storm, in the severe cases of COVID-19 can pass through the blood-brain barrier, enter the brain tissue, and activate the microglial cells and oligodenritcytes. Activation of the microglia cells and oligodenritcytes can increase generation of reactive oxygen species in the brain. Excess generation of reactive oxygen species can in turn increase neuro-inflammation in some cases of patients with COVID-19. Treatment of COVID-19 is far from clear. Today, some antiviral drugs such as remdisivir, favipiravir, ribavirin, kaletra, and arbidol are being tested against the disease. Besides these drugs, corticosteroids, anti-malaria drugs (such as chloroquine family), anticoagulants (such as heparin or enoxaparin) are repurposed. In this paper, first we explained the pathogenesis of COVID-19 particles, particularly in the brain. Second, we reviewed recent treatment options up to now, including interferon therapy, convalescent plasma exchange, plasmapheresis, immunoglobin therapy, and use of specified monoclonal anti-bodies in COVID-19 patients.