Effectiveness of Antiviral and Immunomodulatory Agents in the Treatment of COVID-19: A Systematic Review

Abstract

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) posed a severe threat to global health. Therefore, new findings on effective treatment for symptomatic patients with COVID-19 are considered among emergency issues. This systematic review investigated the effectiveness of pharmacologic interventions in the management of patients with COVID-19. All the articles published in three electronic databases, including Google Scholar, PubMed, and Web of Science, were searched from September 15 to September 30, 2020. Eventually, 24 papers published till September 30 remained to be included in this review. The effectiveness of immunomodulatory and antiviral agents in the treatment of patients with COVID-19 was assessed in this review. The obtained results of the current review rejected the potential of HCQ for the treatment of COVID; however, there was a clinical improvement in patients treated with ruxolitinib in comparison to that reported for the control group. Methylprednisolone, dexamethasone, and calcifediol were suggested as beneficial treatments for patients with COVID-19. The potential efficacy of these antiviral drugs against the SARS-CoV-2 virus is controversial; nevertheless, the triple combination of antiviral and immunomodulatory agents is effective in suppressing the shedding of SARS-CoV-2. There have been no supportive data on the superiority of favipiravir and LPV/r to standard care in the treatment of COVID-19. In addition, no difference was observed between favipiravir and arbidol for the treatment of these patients. There was an association between remdesivir treatment and a reduction of 5 days in clinical improvement among COVID-19 patients. It is required to carry out further RCTs with an in-depth research basis on COVID-19.