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Current evidence for directed and supportive investigational therapies against COVID-19

R van Rensburg1, V Pillay-Fuentes Lorente1, E H Decloedt1

  • 1Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

African Journal of Thoracic and Critical Care Medicine
|July 8, 2021
PubMed

Insights

Effective COVID-19 treatments are urgently needed. Current investigational therapies like hydroxychloroquine show mixed results, and more large-scale trials are required for definitive answers on remdesivir and favipiravir.

Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Clinical Medicine

Background:

  • Coronavirus disease 2019 (COVID-19) presents a significant global health challenge.
  • There is an unmet need for approved and effective therapeutics for COVID-19.
  • Existing clinical trial data for COVID-19 treatments are often limited by small sample sizes and lack of control groups.

Purpose of the Study:

  • To review investigational directed and supportive therapies for COVID-19.
  • To assess the current evidence for various proposed COVID-19 treatments.
  • To highlight the need for further research, particularly large randomized controlled trials.

Main Methods:

  • Literature review of published peer-reviewed results.
  • Analysis of available data on investigational therapies, including chloroquine, hydroxychloroquine, lopinavir/ritonavir, remdesivir, favipiravir, corticosteroids, and tocilizumab.
  • Evaluation of study limitations, such as sample size and control group absence.

Main Results:

  • Chloroquine and hydroxychloroquine show potential but have conflicting trial results.
  • Lopinavir/ritonavir may be effective if initiated early, but was often started late in trials.
  • Remdesivir and favipiravir lack randomized controlled evidence; corticosteroid use is not recommended; tocilizumab's role is unclear.

Conclusions:

  • Early initiation of some investigational therapies may benefit selected COVID-19 patients.
  • Current evidence for many COVID-19 therapies is limited and conflicting.
  • Larger, randomized controlled trials are essential to establish the efficacy and place of these therapies in COVID-19 treatment.
Keywords:
COVID-19ChloroquineHydroxychloroquineInvestigational directed therapiescorticosteroidsfavipiravirlopinavir/ritonavirremdesivirtocilizumab

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