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Biologics in COVID-19 So Far: Systematic Review

Milton Arias1, Henry Oliveros2, Sharon Lechtig1

  • 1Department of Clinical Pharmacology, Evidence-Based Therapeutics Group, Faculty of Medicine, Universidad de La Sabana and Clínica Universidad de La Sabana, Autopista Norte de Bogotá, Chía 140013, Colombia.

Pharmaceuticals (Basel, Switzerland)
|July 27, 2022
PubMed

Insights

Biologics show potential for severe COVID-19, but conclusive evidence is limited. Interleukin-6 (IL-6) and IL-1 inhibitors, interferons, and anti-spike antibodies require further investigation for consistent efficacy.

Area of Science:

  • Immunology
  • Virology
  • Critical Care Medicine

Background:

  • Severe and advanced COVID-19 presents significant treatment challenges.
  • Biologic therapies offer potential mechanisms to modulate the immune response in critical illness.

Purpose of the Study:

  • To systematically review evidence on biologics for severe COVID-19.
  • To identify targets, study methodologies, and efficacy of biologic interventions.

Main Methods:

  • Comprehensive literature search across multiple databases (Cochrane, Embase, PubMed, Medline, medRxiv, Google Scholar) up to January 2022.
  • Qualitative analysis of 90 selected records from 4821 identified studies.
  • Focused on biologic interventions for COVID-19, viral pneumonia, and sepsis.

Main Results:

  • Five main biologic targets identified: IL-6/IL-1 inhibitors, interferons, mesenchymal stem cells, and anti-spike antibodies.
  • Limited consistent and statistically significant efficacy demonstrated across most biologics.
  • Anti-spike antibodies showed some promising results; IL-6/IL-1 inhibitors and interferons indicated potential for improved survival and clinical outcomes.

Conclusions:

  • Current evidence for biologics in severe COVID-19 is largely inconclusive.
  • IL-6/IL-1 inhibitors and interferons show encouraging trends warranting further rigorous research.
  • Standardization of study methodologies is crucial for future biologic trials in COVID-19.
Keywords:
BiopharmaceuticalsCOVID-19Interferon treatmentInterleukin inhibitorsSARS-CoV-2anti-spike monoclonal antibodybiologicsmesenchymal stem cells

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