tetano
Editor, Senior Moderator
Expert Rev Respir Med
. 2021 May 7.
doi: 10.1080/17476348.2021.1927719. Online ahead of print.
Antiviral treatment selection for SARS-CoV-2 pneumonia
Matteo Bassetti[SUP] 1 2 [/SUP], Silvia Corcione[SUP] 3 [/SUP], Silvia Dettori[SUP] 1 2 [/SUP], Andrea Lombardi[SUP] 4 5 [/SUP], Tommaso Lupia[SUP] 3 [/SUP], Antonio Vena[SUP] 2 [/SUP], Francesco Giuseppe De Rosa[SUP] 3 [/SUP], Andrea Gori[SUP] 4 5 6 [/SUP], Daniele Roberto Giacobbe[SUP] 1 2 [/SUP]
Affiliations
Abstract
Introduction: Therapy of coronavirus disease 2019 (COVID-19) involves evolving algorithms that include drugs aimed at reducing disease progression by counteracting two different, but intertwined processes: (i) the damage caused by the virus (with antivirals); (ii) the damage caused by a dysregulated host response (with immunomodulatory agents).
Areas covered: Herein, we discuss the available evidence on efficacy and safety of antiviral agents employed over the past months for the treatment of COVID-19, and the reasons to be considered for antiviral selection.
Expert opinion: The available evidence from randomized controlled trials (RCT) currently discourage the use of lopinavir/ritonavir, hydroxychloroquine, and interferons, which did not show improved efficacy compared to standard care or placebo. Regarding remdesivir, the current body of evidence may conditionally support its use in COVID-19 patients requiring oxygen supplementation but still not requiring invasive mechanical ventilation. Finally, neutralizing monoclonal antibodies have been proven efficacious in reducing the risk of severe disease development if administered early in the course of the disease to patients at risk of progression. The results of ongoing RCT will be certainly crucial to further improve our understanding of the optimal place in therapy of antiviral agents for COVID-19.
Keywords: COVID-19; SARS-CoV-2; antiviral; coronavirus; hydroxychloroquine; lopinavir/ritonavir; remdesivir.
. 2021 May 7.
doi: 10.1080/17476348.2021.1927719. Online ahead of print.
Antiviral treatment selection for SARS-CoV-2 pneumonia
Matteo Bassetti[SUP] 1 2 [/SUP], Silvia Corcione[SUP] 3 [/SUP], Silvia Dettori[SUP] 1 2 [/SUP], Andrea Lombardi[SUP] 4 5 [/SUP], Tommaso Lupia[SUP] 3 [/SUP], Antonio Vena[SUP] 2 [/SUP], Francesco Giuseppe De Rosa[SUP] 3 [/SUP], Andrea Gori[SUP] 4 5 6 [/SUP], Daniele Roberto Giacobbe[SUP] 1 2 [/SUP]
Affiliations
- PMID: 33962524
- DOI: 10.1080/17476348.2021.1927719
Abstract
Introduction: Therapy of coronavirus disease 2019 (COVID-19) involves evolving algorithms that include drugs aimed at reducing disease progression by counteracting two different, but intertwined processes: (i) the damage caused by the virus (with antivirals); (ii) the damage caused by a dysregulated host response (with immunomodulatory agents).
Areas covered: Herein, we discuss the available evidence on efficacy and safety of antiviral agents employed over the past months for the treatment of COVID-19, and the reasons to be considered for antiviral selection.
Expert opinion: The available evidence from randomized controlled trials (RCT) currently discourage the use of lopinavir/ritonavir, hydroxychloroquine, and interferons, which did not show improved efficacy compared to standard care or placebo. Regarding remdesivir, the current body of evidence may conditionally support its use in COVID-19 patients requiring oxygen supplementation but still not requiring invasive mechanical ventilation. Finally, neutralizing monoclonal antibodies have been proven efficacious in reducing the risk of severe disease development if administered early in the course of the disease to patients at risk of progression. The results of ongoing RCT will be certainly crucial to further improve our understanding of the optimal place in therapy of antiviral agents for COVID-19.
Keywords: COVID-19; SARS-CoV-2; antiviral; coronavirus; hydroxychloroquine; lopinavir/ritonavir; remdesivir.