Yadav Ambedkar Kumar, Wen Siwan, Xu Xianghuai, Yu Li
Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji University School of Medicine, Shanghai, China.
Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji University School of Medicine, Shanghai, China. Email:
Ann Palliat Med. 2021 Jan;10(1):707-720. doi: 10.21037/apm-20-1755. Epub 2021 Jan 11.
The whole world is battling through coronavirus disease 2019 (COVID-19) which is a fatal pandemic. In the early 2020, the World Health Organization (WHO) declared it as a global health emergency without definitive treatments and preventive approaches. In the absence of definitive therapeutic agents, this thorough review summarizes and outlines the potency and safety of all molecules and therapeutics which may have potential antiviral effects. A number of molecules and therapeutics licensed or being tested for some other conditions were found effective in different in vitro studies as well as in many small sample-sized clinical trials and independent case studies. However, in those clinical trials, there were some limitations which need to be overcome to find the most promising antiviral against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In conclusion, many of above-mentioned antivirals seems to have some therapeutic effects but none of them have been shown to have a strong evidence for their proper recommendation and approval in the treatment of COVID-19. Constantly evolving new evidences, exclusive adult data, language barrier, and type of study (observational, retrospective, small-sized clinical trials, or independent case series) resulted to the several limitations of this review. The need for multicentered, large sample-sized, randomized, placebo-controlled trials on COVID-19 patients to reach a proper conclusion on the most promising antiviral agent is warranted.
全球正在与2019冠状病毒病（COVID-19）作斗争，这是一场致命的大流行病。2020年初，世界卫生组织（WHO）宣布其为全球卫生紧急事件，当时尚无明确的治疗方法和预防措施。在缺乏明确治疗药物的情况下，本全面综述总结并概述了所有可能具有潜在抗病毒作用的分子和疗法的效力及安全性。一些已获许可或正在针对其他病症进行测试的分子和疗法，在不同的体外研究以及许多小样本量的临床试验和独立病例研究中被发现有效。然而，在这些临床试验中，存在一些需要克服的局限性，以便找到针对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）最有前景的抗病毒药物。总之，上述许多抗病毒药物似乎都有一定的治疗效果，但在治疗COVID-19方面，尚无有力证据支持对它们进行恰当推荐和批准。不断演变的新证据、仅有的成人数据、语言障碍以及研究类型（观察性、回顾性、小样本量临床试验或独立病例系列）导致了本综述存在若干局限性。有必要针对COVID-19患者开展多中心、大样本量、随机、安慰剂对照试验，以便就最有前景的抗病毒药物得出恰当结论。
