Therapeutic alternatives for the management of COVID-19
Keywords:
coronavirus, COVID-19, SARS-CoV-2, treatment.Abstract
Introduction: COVID-19 is a pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), so far there is no fully effective specific treatment for this disease, but worldwide effort is incessant in the search for a cure.
Objective: To describe the therapeutic alternatives for COVID-19 according to the pathophysiological mechanisms described up until now.
Material and Method: A bibliographic review was made from a total of 31 bibliographic references. Articles, in English and Spanish, from national and international journals were searched over on-line databases such as Pubmed/Medline and Elsevier. The quality, reliability and validity of the selected articles were analyzed to carry out an adequate review.
Development: The appearance of COVID-19 has caused an international stir due to the need to find effective treatments. Because it is a frequently self-limited disease, it becomes difficult to prove whether a therapeutic strategy is effective or the disease has run its course. The SARS-CoV viral life cycle phases provide potential targets for drug therapy, such as: viral envelope membrane fusion inhibitors, 3-chymotrypsin-like protease inhibitors, virus RNA-dependent RNA polymerase, endocytosis and entry inhibitors, and other medications with some immunomodulatory function.
Conclusions: The current pandemic represents a challenge for the international medical community. Although there is no specific recommended treatment, various drugs are used with some effectiveness such as hydroxychloroquine, azithromycin, kaletra and remdesivir with their respective combinations.
Downloads
References
1.Pérez Abreu MR, Gómez Tejeda JJ, Diéguez Guach RA. Características clínico-epidemiológicas de la COVID-19. Rev haban cienc méd [Internet]. 2020 [Citado 25/04/220];19(2):e_3254. Disponible en: http://www.revhabanera.sld.cu/index.php/rhab/article/view/3254/2505
2. World Health Organization. Clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspected [Internet]. Ginebra: World Health Organization;2020 [Citado 17/04/2020]. Disponible en:https://www.who.int/publications-detail/clinical-management-of-severe-acute-respiratory-infection-when-novel-coronavirus-(ncov)-infection-is-suspected
3. Ministerio de Salud Pública. Protocolo Nacional MINSAP vs COVID-19. La Habana: MINSAP; 2020 [Citado 10/04/2020]. Disponible en: https://www.salud.msp.gob.cu
4. Centro Nacional de Información de Ciencias Médicas. Actualización epidemiológica. Nuevo coronavirus (2019-nCoV) [Internet]. La Habana: Centro Nacional de Información de Ciencias Médicas; 2020 [Citado 17/04/2020]. Disponible en: https://temas.sld.cu/coronavirus/2020/01/28/nuevo-coronavirus-2019-ncov-actualizacion
5. Chih Cheng L. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. International Journal of Antimicrobial Agents [Internet]. 2020 Mar [Citado 17/04/2020];55(3):[aprox. 4 p.]. Disponible en: https://doi.org/10.1016/j.ijantimicag.2020.105924
6. X. Li. Molecular immune pathogenesis and diagnosis of COVID-19. Journal of Pharmaceutical Analysis [Internet]. 2020 [Citado 17/05/2020];10(1):[aprox. 2 p.]. Disponible en: https://doi.org/10.1016/j.jpha.2020.03.001
7. Sanders J, et al. Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19): A review. JAMA [Internet]. 2020 April [Citado 17/04/2020];323:[aprox. 2 p.]. Disponible en: https://doi.org/10.1001/jama.2020.6019
8. Zhu Z, Lu Z, Xu T. Arbidol monotherapy is superior to lopinavir/ritonavir in treating COVID-19. Journal of Infection [Internet]. 2020 [Citado 18/04/2020]; 21:5. Disponible en: https://doi.org/10.1016/j.jinf.2020.03.060
9. Bittmann S, Luchter E, Moschüring Alieva E, Villalon G, Weissenstein A. COVID 19: Camostat and The Role of Serine Protease Entry Inhibitor TMPRSS2. J Regen Biol Med [Internet]. 2020 [Citado 22/04/20];2(2):1-2. Disponible en: https://doi.org/10.37191/Mapsci-2582-385X-2(2)-020
10. Harapan H. Coronavirus disease 2019 (COVID-19): A literature review. Journal of Infection and Public Health [Internet]. 2020 Abr [Citado 17/05/2020];13:[aprox. 2 p.]. Disponible en: https://doi.org/10.1016/j.jiph.2020.03.019
11. Gendrot M , Javelle E , Le Dault E, Clerc A , Savini H , Pradines B. Chloroquine as prophylactic agent against COVID-19?. Int J of Antimicrobial Agents [Internet]. 2020 [Citado 16/04/2020];55:[aprox. 1 p.]. Disponible en: https://doi.org/10.1016/j.ijantimicag.2020.105980
12. Cortegiani G, Ingoglia MI. A systematic review on the efficacy and safety of chloroquine for the treatment of COVID-19. Journal of Critical Care [Internet]. 2020 Mar [Citado 20/04/2020];55:[aprox. 3 p.]. Disponible en: https://doi.org/10.1016/j.jcrc.2020.03.005
13. Fantini J, Di Scala Cl. Structural and molecular modelling studies reveal a new mechanism of action of chloroquine and hydroxychloroquine against SARS-CoV-2 infection. Int J Antimicrobial Agents [Internet]. 2020 Apr [Citado 17/04/2020];55:[aprox. 2 p.]. . Disponible en: https://doi.org/10.1016/j.ijantimicag.2020.105960
14. Gautret P, Lagier JC, Parola P. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non randomized clinical trial. Int J Antimicrob Agents [Internet]. 2020 Mar [Citado 17/04/2020];55:[aprox. 2 p.]. Disponible en: https://doi.org/10.1016/j.ijantimicag.2020.105949
15. Devaux CA, Rolain JM, Colson P, Raoult D. New in sights on the antiviral effects of chloroquine against coronavirus: what to expect for COVID-19? Int J Antimicrob Agents [Internet]. 2020 Mar [Citado 17/04/2020];55:[aprox. 2 p.]. Disponible en: https://doi.org/10.1016/j.ijantimicag.2020.105938
16. Coutard B. The spike glycoprotein of the new coronavirus 2019-nCoV contains a furinlike cleavage site absent in CoV of the same clade. Antiviral Research [Internet]. 2020 Apr [Citado 17/05/2020];176:[aprox. 3 p.]. Disponible en: https://doi.org/10.1016/j.antiviral.2020.104742
17. Tang T. Coronavirus membrane fusion mechanism offers as a potential target for antiviral development. Antiviral Research [Internet]. 2020 Apr [Citado 17/04/2020];2020(176):[aprox. 2 p.]. Disponible en: https://doi.org/10.1016/j.antiviral.2020.104792
18. Dong L, Hu S, Gao J. Discovering drugs to treat coronavirus disease 2019 (COVID-19). Drug Discoveries & Therapeutics [Internet]. 2020 [Citado 17/04/2020];14(1):58-60. Disponible en: https://doi.org/10.5582/ddt.2020.01012
19. Choy K T. Remdesivir, lopinavir, emetine, and homoharringtonine inhibit SARS-CoV-2 replication in vitro. Antiviral Research [Internet]. 2020 [Citado 17/04/2020];178(104):786. Disponible en: https://doi.org/10.1016/j.antiviral.2020.104786
20. Cao B, Wang Y, Wen D. A trial of lopinavir-ritonavir in adults hospitalized with severe COVID-19. N Engl J Med [Internet]. 2020 [Citado 18/04/2020];382:[aprox. 2 p.]. Disponible en: https://doi.org/10.1056/NEJMoa2001282
21. Jean SS. Treatment options for COVID-19: The reality and challenges. J Microbiology, Immunology and Infection [Internet]. 2020 Abr [Citado 17/04/2020];51:[aprox. 1 p.]. Disponible en: https://doi.org/10.1016/j.jmii.2020.03.034
22. Rismanbaf A. Potential Treatments for COVID-19; a Narrative Literature Review. Arch Acad Emerg Mede [Internet]. 2020 [Citado 18/04/2020];8(1):e29. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7085862/
23. Mehta N, Mazer Amirshahi M, Alkindi N. Pharmacotherapy in COVID-19; A narrative review for emergency providers. Am J Emergency Medicine [Internet]. 2020 [Citado 17/04/2020];38:[aprox. 2 p.]. Disponible en: https://doi.org/10.1016/j.ajem.2020.04.035
24. Zhai P, Ding Y, Wu X. The epidemiology, diagnosis and treatment of COVID-19. Int J Antimicrobial Agents [Internet]. 2020 Mar [Citado 17/04/2020]; 55(3): [aprox. 2 p.]. Disponible en: https://doi.org/10.1016/j.ijantimicag.2020.105955
25. Department of Mechanical and Manufacturing Engineering. Current Drugs with Potential for Treatment of COVID-19: A Literature Review: Drugs for the Treatment Process of COVID-19. J Pharm Pharm Sci [Internet]. 2020 [Citado 20/04/2020];23(1):58-4. Disponible en: https://journals.library.ualberta.ca/jpps/index.php/JPPS/article/view/31002
26. Guangdi L. De Clercq E. Therapeutic options for the 2019 novel coronavirus (2019-nCoV). Nature Reviews Drug Discovery [Internet]. 2020 [Citado 17/04/202];19:149-50. Disponible en: https://media.nature.com/original/magazine-assets/d41573-020-00016-0/d41573-020-00016-0.pdf
27. Zhao M. Cytokine storm and immunomodulatory therapy in COVID-19:role of chloroquine and anti-IL-6 monoclonal antibodies. International Journal of Antimicrobial Agents [Internet]. 2020 [Citado 17/04/2020];55:[aprox. 2 p.]. Disponible en: https://doi.org/10.1016/j.ijantimicag.2020.105982
28. Carlos WG, Cruz CSD, Cao B, Pasnick S, Jamil S. Novel Wuhan (2019-nCoV) Coronavirus. Am J Respir Critic Care Med [Internet]. 2020 [Citado 16/04/2020];201(4):7-8. Disponible en: https://doi.org/10.1164/rccm.2014P7
29. Gauna ME, Bernava JL. Recomendaciones diagnostica y terapéuticas ante la Respuesta Inmune Trombotica Asociada a COVID-19 (RITAC). CorSalud [Internet]. 2020 [Citado 14/05/2020];12(1):60-3. Disponible en: http://www.revcorsalud.sld.cu/index.php/cors/article/view/615
30. Cepero Llauger K, Pardo Ramírez I, Gómez León M. Respuesta inmunitaria y trombótica en pacientes con síndrome de dificultad respiratoria aguda en la neumonía por SARS-CoV-2. Anales de la Academia de Ciencias de Cuba [Internet]. 2020 [Citado 14/05/2020];10(2):[aprox. 1 p.]. Disponible en: http://www.revistaccuba.sld.cu/index.php/revacc/article/view/782
31. Huang C. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet [Internet]. 2020 [Citado 17/04/2020];395(10223): 497-506. Disponible en: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30183-5/fulltext
32. Wu C, Liu Y, Yang Y. Analysis of therapeutic targets for SARS-CoV-2 and discovery of potential drugs by computational methods. Acta Pharmaceutica Sinica B [Internet]. 2020 Feb [Citado 17/04/2020];10:[aprox. 2 p.]. Disponible en: https://doi.org/10.1016/j.apsb.2020.02.008
33. Calvo C. Recomendaciones sobre el manejo clínico de la infección por el nuevo coronavirus SARS-CoV2. An Pediatr (Barc) [Internet]. 2020 [Citado 16/04/2020];30(20):11. Disponible en: https://doi.org/10.1016/j.anpedi.2020.02.001
Download PDF
