Emerging Therapies
Antivirals
Various antivirals (monotherapy and combination therapy) are being trialed in patients with COVID-19 (e.g., oseltamivir, lopinavir/ritonavir, ganciclovir, favipiravir, baloxavir marboxil, umifenovir, ribavirin, interferon alfa); however, there are no data to support their use. [6] [7] [8] [107] [108] [109] [110] [111] [112] [113] Results from one small case series found that evidence of clinical benefit with lopinavir/ritonavir was equivocal. [114] Remdesivir shows in vitro activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has been used to treat patients in China, as well as the first patient in the US. [115] [116] Clinical trials with remdesivir have started in the US and in China. [117] [118] [119]
Intravenous immune globulin
Intravenous immune globulin is being trialed in some patients with COVID-19; however, there are no data to support this. [7]
Chloroquine and hydroxychloroquine
Chloroquine and hydroxychloroquine are being trialed in some patients with COVID-19. [120] [121] [122] Chloroquine shows in vitro activity against SARS-CoV-2. [116] An expert consensus guideline in China recommends chloroquine in mild to severe cases of COVID-19 as it may improve the success rate of treatment, shorten hospital stay, and improve patient outcome. [123]
Traditional Chinese Medicine
Traditional Chinese Medicine is being trialed in some patients with COVID-19 (e.g., Xue-Bi-Jing, Shuang-Huang-Lian, Xin-Guan-2); however, there are no data to support this. [124] [125] [126] These medicines are commonly used in China to treat COVID-19 patients. [127]
Stem cell therapy
Stem cell therapy is being investigated to treat patients with COVID-19 in clinical trials. It is thought that mesenchymal stem cells can reduce the pathologic changes that occur in the lungs, and inhibit the cell-mediated immune inflammatory response. [128]
Angiotensin-II receptor antagonists
Angiotensin-II receptor antagonists such as losartan are being investigated as a potential treatment because it is thought that the angiotensin-converting enzyme-2 (ACE2) receptor is the main binding site for the virus. [129]
Convalescent plasma
Convalescent plasma from patients who have recovered from viral infections has been used as a treatment in previous virus outbreaks including SARS, avian influenza, and Ebola virus infection. [130] A clinical trial to determine the safety and efficacy of convalescent plasma in patients with COVID-19 has started in China; however, there is no data on its use as yet.
Antivirals
Various antivirals (monotherapy and combination therapy) are being trialed in patients with COVID-19 (e.g., oseltamivir, lopinavir/ritonavir, ganciclovir, favipiravir, baloxavir marboxil, umifenovir, ribavirin, interferon alfa); however, there are no data to support their use. [6] [7] [8] [107] [108] [109] [110] [111] [112] [113] Results from one small case series found that evidence of clinical benefit with lopinavir/ritonavir was equivocal. [114] Remdesivir shows in vitro activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has been used to treat patients in China, as well as the first patient in the US. [115] [116] Clinical trials with remdesivir have started in the US and in China. [117] [118] [119]
Intravenous immune globulin
Intravenous immune globulin is being trialed in some patients with COVID-19; however, there are no data to support this. [7]
Chloroquine and hydroxychloroquine
Chloroquine and hydroxychloroquine are being trialed in some patients with COVID-19. [120] [121] [122] Chloroquine shows in vitro activity against SARS-CoV-2. [116] An expert consensus guideline in China recommends chloroquine in mild to severe cases of COVID-19 as it may improve the success rate of treatment, shorten hospital stay, and improve patient outcome. [123]
Traditional Chinese Medicine
Traditional Chinese Medicine is being trialed in some patients with COVID-19 (e.g., Xue-Bi-Jing, Shuang-Huang-Lian, Xin-Guan-2); however, there are no data to support this. [124] [125] [126] These medicines are commonly used in China to treat COVID-19 patients. [127]
Stem cell therapy
Stem cell therapy is being investigated to treat patients with COVID-19 in clinical trials. It is thought that mesenchymal stem cells can reduce the pathologic changes that occur in the lungs, and inhibit the cell-mediated immune inflammatory response. [128]
Angiotensin-II receptor antagonists
Angiotensin-II receptor antagonists such as losartan are being investigated as a potential treatment because it is thought that the angiotensin-converting enzyme-2 (ACE2) receptor is the main binding site for the virus. [129]
Convalescent plasma
Convalescent plasma from patients who have recovered from viral infections has been used as a treatment in previous virus outbreaks including SARS, avian influenza, and Ebola virus infection. [130] A clinical trial to determine the safety and efficacy of convalescent plasma in patients with COVID-19 has started in China; however, there is no data on its use as yet.
