CC BY-NC-ND 4.0 · Journal of Digestive Endoscopy 2020; 11(01): 69-72
DOI: 10.1055/s-0040-1712547
Review Article

Emerging Treatment and Prevention Strategies against COVID-19: A Brief Update

1  Department of Gastroenterology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
,
Ravikant Kumar
1  Department of Gastroenterology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
,
Mahesh K. Goenka
2  Institute of GastroSceinces, Apollo Gleneagles Hospital, Kolkata, West Bengal, India
,
Vishwa M. Dayal
1  Department of Gastroenterology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
› Author Affiliations
  

Abstract

Patients with novel coronavirus disease 2019 (COVID-19) are at significantly increased risk for mortality and morbidity. Current management remains supportive care, ranging from symptomatic outpatient management to full–intensive care support, including intravenous fluids, invasive, and non-invasive oxygen supplementation. In patients with septic shock, treatment with antibiotics and vasopressors are recommended to keep mean arterial pressure (MAP) ≥ 65 mm Hg and lactate < 2 mmol/L. Because of the lack of effectiveness and possible adverse effects, routine corticosteroids should be avoided unless they are indicated for another reason (exacerbation of asthma or chronic obstructive pulmonary disease [COPD], and septic shock in whom fluids and vasopressors do not restore hemodynamic stability). There is currently no sufficient evidence of efficacy of hydroxychloroquine/chloroquine, remdesivir, and other antivirals in the treatment or prevention of COVID-19. Limited evidence shows that COVID-19 convalescent plasma can be used as a treatment of COVID-19 without the occurrence of severe adverse events. Drug regulatory agencies granted an emergency-use authorization of chloroquine/hydroxychloroquine and remdesivir to treat patients when a clinical trial is not available or participation is not feasible. Chloroquine and hydroxychloroquine are associated with QT interval prolongation and life-threatening cardiac arrhythmia in patients with pre-existing cardiovascular disease. Guidelines are issued for use of convalescent plasma in patients with serious or immediately life-threatening COVID-19. Data from several ongoing randomized controlled trials will provide further evidence regarding the safety and efficacy of these drugs for the treatment of COVID-19.



Publication History

Publication Date:
16 May 2020 (online)

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