TY - JOUR
T1 - Antiviral treatment selection for SARS-CoV-2 pneumonia
AU - Bassetti, Matteo
AU - Corcione, Silvia
AU - Dettori, Silvia
AU - Lombardi, Andrea
AU - Lupia, Tommaso
AU - Vena, Antonio
AU - De Rosa, Francesco Giuseppe
AU - Gori, Andrea
AU - Giacobbe, Daniele Roberto
N1 - Publisher Copyright:
© 2021 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2021
Y1 - 2021
N2 - 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 the 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 discourages 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 the ongoing RCT will certainly be crucial to further improve our understanding of the optimal place in therapy of antiviral agents for COVID-19.
AB - 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 the 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 discourages 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 the ongoing RCT will certainly be crucial to further improve our understanding of the optimal place in therapy of antiviral agents for COVID-19.
KW - antiviral
KW - coronavirus
KW - COVID-19
KW - hydroxychloroquine
KW - lopinavir/ritonavir
KW - remdesivir
KW - SARS-CoV-2
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U2 - 10.1080/17476348.2021.1927719
DO - 10.1080/17476348.2021.1927719
M3 - Review article
C2 - 33962524
AN - SCOPUS:85106278795
JO - Expert Review of Respiratory Medicine
JF - Expert Review of Respiratory Medicine
SN - 1747-6348
ER -