Pharmacological Treatment of Patients with Mild to Moderate COVID-19: A Comprehensive Review

Mild to moderate COVID-19 can be found in about 80% of patients. Although mortality is low, mild to moderate COVID-19 may progress to severe or even critical stages in about one week. This poses a substantial burden on the health care system, and ultimately culminates in death or incapacitation and...

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Veröffentlicht in:International journal of environmental research and public health 2021-07, Vol.18 (13), p.7212
Hauptverfasser: Bestetti, Reinaldo B, Furlan-Daniel, Rosemary, Silva, Vinicius M R
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creator Bestetti, Reinaldo B
Furlan-Daniel, Rosemary
Silva, Vinicius M R
description Mild to moderate COVID-19 can be found in about 80% of patients. Although mortality is low, mild to moderate COVID-19 may progress to severe or even critical stages in about one week. This poses a substantial burden on the health care system, and ultimately culminates in death or incapacitation and hospitalization. Therefore, pharmacological treatment is paramount for patients with this condition, especially those with recognized risk factors to disease progression. We conducted a comprehensive review in the medical literature searching for randomized studies carried out in patients with mild to moderate COVID-19. A total of 14 randomized studies were identified, enrolling a total of 6848 patients. Nine studies (64%) were randomized, placebo-controlled trials, whereas five were open-label randomized trials (35%). We observed that Bamlanivimab and nitazoxanide reduced viral load, whereas ivermectin may have shortened time to viral clearance; Interferon Beta-1 reduced time to viral clearance and vitamin D reduced viral load; Favirapir, peginterferon, and levamisole improved clinical symptoms, whereas fluvoxamine halted disease progression; inhaled budesonide reduced the number of hospitalizations and visits to emergency departments; colchicine reduced the number of deaths and hospitalizations. Collectively, therefore, these findings show that treatment of early COVID-19 may be associated with reduced viral load, thus potentially decreasing disease spread in the community. Moreover, treatment of patients with mild to moderate COVID-19 may also be associated with improved clinical symptoms, hospitalization, and disease progression. We suggest that colchicine, inhaled budesonide, and nitazoxanide, along with nonpharmacological measures, based on efficacy and costs, may be used to mitigate the effects of the COVID-19 pandemic in middle-income countries.
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subjects Acids
Budesonide
Clinical trials
Colchicine
Coronaviruses
COVID-19
COVID-19 vaccines
Developing countries
Disease spread
Drug dosages
Emergency medical services
Fluvoxamine
Health risks
Health services
Hospitalization
Humans
Illnesses
Interferon
Ivermectin
LDCs
Levamisole
Literature reviews
Oxygen saturation
Pandemics
Patients
Pharmacology
Pneumonia
Review
Risk analysis
Risk factors
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
Signs and symptoms
Treatment Outcome
Viral infections
Viral Load
Vitamin D
Vitamin deficiency
title Pharmacological Treatment of Patients with Mild to Moderate COVID-19: A Comprehensive Review
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