CHAPTER 6: Therapeutic Options Initially Available for COVID-19 Patients and Initial Clinical Trials
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Published:27 Apr 2022
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Special Collection: 2022 ebook collection
S. Cho, C. Hughes, I. Mahalaxmi, M. D. Subramaniam, B. Vellingiri, and S. Warren, in The Coronavirus Pandemic and the Future Volume 1, ed. M. D. Waters, A. Dhawan, T. Marrs, D. Anderson, S. Warren, C. L. Hughes, ... C. L. Hughes, The Royal Society of Chemistry, 2022, pp. 136-164.
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The unforeseen outbreak of the novel coronavirus 2019, designated severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2), has created a major crisis globally. Researchers and scientists are urgently designing and developing vaccines and testing the efficacy of drugs available to treat this deadly infection. This chapter focuses on updates regarding various therapeutic options available to treat the infection, which include repurposed target-specific and broad-spectrum antiviral drugs as well as various Chinese and Indian medicinal plants, and convalescent plasma. Numerous stem cell based therapies also have been under scrutiny for the possible treatment of coronavirus disease 2019 (COVID-19). These studies have provided some evidence to support the usage of multiple alternative antiviral therapies against COVID-19 while clinical trials are still underway. The antiviral drug remdesivir, initially used to treat Ebola, was given emergency use authorization by the United States Food and Drug Administration on 1 May 2020 to treat suspected or laboratory confirmed COVID-19 in adults and children hospitalized with severe disease, 2 days after the National Institutes of Health's clinical trial showed promising results in shortening the duration of disease by an average of 4 days. Subsequently, dexamethasone, an off-patent steroid used since the 1960s, resulted in approximately a one-third mortality reduction in a clinical trial done in the United Kingdom in patients with COVID-19 who were on ventilators and approximately a one-fifth mortality reduction in patients requiring oxygen. No benefit was seen in patients with milder disease. Clearly, more research is needed on novel options, including combination therapies, that will enable us to develop more rational countermeasures against COVID-19.