Abstract
Background: The effective responses of both innate and adaptive immunity are crucial in combating Novel-Coronavirus-2 infection. An excessive response may lead to cytokine storm, which is a challenging problem in therapeutic strategies. Methods: A systematic review was carried out by searching OVID MEDLINE, PUBMED, Google Scholar, and Cochrane library databases from inception until August 2, 2020, for anti-inflammatory and immunomodulatory drugs against coronavirus disease 2019 (COVID-19). Results: The results of the effectiveness of Hydroxychloroquine are just like a sinusoidal diagram and in a state of ambiguity. Thalidomide was effective in some cases but has not yet been proven. Low-dose Corticosteroids may be effective in the early stages of the illness as a bridge. There is no evidence of benefits or adverse outcomes for the use of non-steroidal anti-inflammatory drugs and Cyclosporine-A. In some critically ill patients, Interleukin-6 (IL-6) and IL-1 blockers and to some extent Tumor-Necrosis-Factor-α and Janus-Kinase inhibitors are useful. Finally, high-dose intravenous immunoglobulin reversed the deterioration of patients in most trials. Conclusion: One strategy behind the treatments for COVID-19 is based on breaking the cytokine storm. Although avoiding the suppression of anti-viral immunity is crucial by choosing the weaker and more selective anti-inflammatories, some strategies are kept for hyper-inflammatory situations. Scheduling of treatment is also important. Although low-dose steroids may be effective in the early stages of the illness, "Tocilizumab" is more effective in severe situations, when the IL-6 level is high and other drugs are ineffective. Therefore, consideration should be given to each patient separately.
Publisher
Maad Rayan Publishing Company
Subject
General Pharmacology, Toxicology and Pharmaceutics,Pharmaceutical Science
Cited by
5 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献