Abstract
Background: Coronavirus disease 2019 (COVID-19) was originated first in Wuhan, China, in December 2019, and it is known to be caused by severe acute respiratory syndrome coronavirus- 2 (SARS CoV-2). The management of COVID-19 could be achieved by means of the usage of the repurposed drugs, inhibiting the viral entry and/or viral fusion such as umifenovir, Baricitinib, Camostat mesylate, Nafamostat mesylate, and the drugs blocking the viral replication, which include favipiravir, remdesivir, Lopinavir/ritonavir, Ribavirin, Sofosbuvir, chloroquine and Hydroxychloroquine.
Objective: Along with the drugs that target the SARS-CoV-2 virus, adjunctive therapies are also employed. This review focuses on the adjuvant therapies employed to manage the COVID-19-associated complications, such as cytokine storm, acute respiratory distress syndrome (ARDS), respiratory failure, cardiac injury, coagulopathy, and multi-organ failure.
Methods: The literature was searched in databases such as Medline/PubMed Central/PubMed, Google Scholar, Science Direct, EBSCO, Scopus, EMBASE, Directory of open access journals (DOAJ), and reference lists to identify relevant articles.
Results: Various studies have been identified for the use of corticosteroids, interferons, monoclonal antibodies, etoposide, ruxolitinib, anticoagulants, convalescent plasma, immunoglobulins, mesenchymal stem cells, natural killer (NK) cells, and inhaled nitric oxide (NO) as adjuvant therapy to manage the patients with COVID-19 along with the repurposed drugs targeting SARS-CoV-2.
Conclusion: The safety and efficacy of adjuvant therapy are needed to be confirmed by various ongoing randomized controlled clinical trials.
Keywords: SARS CoV-2, COVID-19, adjuvant therapy, cytokine storm, acute respiratory distress syndrome, multi-organ failure, coagulopathy.
Graphical Abstract
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