TREATMENT STRATEGIES

Most people infected with COVID-19 develop mild symptoms (or no symptoms at all) and ​do not need special treatment. However, many people develop severe symptoms requiring hospital treatment and in a considerable amount of cases contracting COVID-19 can lead to death1. As it is a very recent disease, there is no specific vaccine or antiviral available yet. Due to the pandemic character of COVID-19, it is critical to identify the drug treatment options as soon as possible.

Antivirals

The use of antivirals can help inhibit the spread of the virus. To discover the potential antiviral treatment of SARS-CoV-2, several approaches are being implemented. One includes testing the already existing broad-spectrum antiviral drugs. These drugs are used for treating other viral diseases, such as influenza, malaria, SARS, MERS or against HIV, and if effective, they could be quickly repurposed to treat COVID-192.

Another approach is to screen a chemical library containing many chemical compounds or databases. This method can identify candidate substances that can be further tested. It is noteworthy that even some natural products, e.g., those used in eastern medicine, have been reported to help treat COVID-193.

Nowadays, in silico screens can significantly contribute to the drug search. These can screen large databases of already existing compounds and even lead to the design of new specific drugs based on the characteristics of SARS-CoV-2.

China, being the first country with COVID-19, has had the longest time and opportunity to evaluate and plan a treatment strategy for their patients. Their National Health Commission issued the Guidelines for the Prevention, Diagnosis, and Treatment of Novel Coronavirus-induced Pneumonia, which recommend the use antivirals including interferon alpha, lopinavir/ritonavir, ribavirin, chloroquine phosphate and arbidol3.

Vaccine

Scientists from all over the world are in a high-prioritized pursuit of a vaccine for COVID-19. However, vaccine development is a time-demanding process. Multiple candidate vaccines are currently being evaluated. As​ ​of March 26, 2 candidate vaccines are reported to be in clinical evaluation and 52 in preclinical studies4.

Other treatment

It is important to also consider adjunctive therapies that could help patients with COVID-19, such as convalescent plasma (plasma from patients having recovered from COVID-19, containing antibodies against the virus) or immunomodulatory agents5. The use of antibiotics is not effective against the virus, but viral infections often facilitate complementary bacterial infections, for which appropriate antibiotics must be used.

In severe cases, widespread inflammation in the lungs can lead to acute respiratory distress syndrome, which requires oxygen supplementation or even extracorporeal membrane oxygenation. This requires special medical equipment, which is limited, and that is one of the reasons why we must do our best to slow the spread of COVID-19.

References