Abubakar Abdullahi Rabiu, Sani Ibrahim Haruna, Godman Brian, Kumar Santosh, Islam Salequl, Jahan Iffat, Haque Mainul
Department of Pharmacology and Therapeutics, Faculty of Pharmaceutical Sciences, Bayero University, Kano, Nigeria.
Unit of Pharmacology, College of Health Sciences, Yusuf Maitama Sule University, Kano, Nigeria.
Infect Drug Resist. 2020 Dec 29;13:4673-4695. doi: 10.2147/IDR.S289037. eCollection 2020.
A novel coronavirus-2 (SARS-CoV-2) was first identified in Wuhan, China, and quickly spread globally. Several treatments have been proposed, many of which have proven ineffective. Consequently, there is a need to review the published evidence of drug clinical trials to guide future prescribing. A systematic review of published clinical trials and retrospective observational studies was carried out. The search was made using PubMed, Embase, MEDLINE, and China National Knowledge Infrastructure (CNKI) databases. Articles published between January 2020 and October 2020 and written in the English language were retrieved and included in the study. Researches that used traditional medicine, in-vitro and in-vivo animal studies, as well as reviews were excluded. Seventy-three relevant articles that fulfilled the inclusion criteria were finally selected and reviewed. Hydroxychloroquine, chloroquine, and azithromycin produced no clinical evidence of efficacy in randomized controlled clinical trials (RCT). However, retrospective observational studies reported the efficacy of remdesivir and lopinavir/ritonavir in reducing viral load, although there have been concerns with lopinavir/ritonavir and, more recently, remdesivir. Recently, tocilizumab, dexamethasone, and methylprednisolone significantly relieved lung inflammation and decreased mortality in patients with severe COVID-19. In addition, convalescent plasma was effective in boosting strong immunity among patients with mild COVID-19. There is currently no single worldwide approved therapeutic option for patients with COVID-19 despite the initial hype with medicines, including hydroxychloroquine. Nonetheless, dexamethasone has shown promise in symptomatic treatment and convalescent plasma in boosting immunity. New treatments are currently being researched, and the findings will be reported accordingly to provide evidence-based guidance for prescribers and policymakers.
新型冠状病毒2（SARS-CoV-2）最初在中国武汉被发现，并迅速在全球传播。已经提出了几种治疗方法，但其中许多已被证明无效。因此，有必要回顾已发表的药物临床试验证据，以指导未来的处方。对已发表的临床试验和回顾性观察性研究进行了系统评价。检索使用了PubMed、Embase、MEDLINE和中国知网（CNKI）数据库。检索并纳入了2020年1月至2020年10月期间发表的英文文章。排除了使用传统医学、体外和体内动物研究以及综述的研究。最终选择并审查了73篇符合纳入标准的相关文章。在随机对照临床试验（RCT）中，羟氯喹、氯喹和阿奇霉素没有产生有效的临床证据。然而，回顾性观察性研究报告了瑞德西韦和洛匹那韦/利托那韦在降低病毒载量方面的疗效，尽管人们对洛匹那韦/利托那韦以及最近对瑞德西韦存在担忧。最近，托珠单抗、地塞米松和甲泼尼龙显著缓解了重症COVID-19患者的肺部炎症并降低了死亡率。此外，康复期血浆对轻症COVID-19患者增强强大免疫力有效。尽管最初对包括羟氯喹在内的药物大肆炒作，但目前全球范围内尚无针对COVID-19患者的单一获批治疗方案。尽管如此，地塞米松在对症治疗方面显示出前景，康复期血浆在增强免疫力方面也有效果。目前正在研究新的治疗方法，并将相应报告研究结果，为处方医生和政策制定者提供循证指导。
