Table 2.
Latest recommendations on most commonly considered therapeutic agents in COVID-19 treatment
| Pharmacologic category | Drug name | Latest recommendations | Ref. |
|---|---|---|---|
| Antiviral drugs | Remdesivir |
• Received FDA approval for COVID-19 treatment. • Recommended for the treatment of both hospitalized and non-hospitalized COVID-19 patients. • Remdesivir can be administered without dose adjustment in COVID-19 patients with renal dysfunction (eGFR < 30 mL/min) and also in patients who are on dialysis. |
[34, 36–38] |
| Ritonavir-boosted nirmatrelvir (Paxlovid) |
• Received Emergency Use Authorizations (EUA) from the FDA for the COVID-19 treatment. • Recommended for the treatment of non-hospitalized COVID-19 patients. |
[34, 39, 40] | |
| Molnupiravir | Only should be used in non-hospitalized patients when Remdesivir and Paxlovid are not available. | [34, 39, 41] | |
| Anti-SARS-CoV-2 monoclonal antibodies | Bebtelovimab | Recommended the use for mild to moderate COVID-19 only when remdesivir and Paxlovid are not available. | [34, 42, 43] |
| Vilobelimab | Emergency Use Authorization (EUA) by Food and Drug Administration (FDA) to administer within 48 h of mechanical ventilation or extracorporeal membrane oxygenation (ECMO) in hospitalized adult COVID-19 patients. | [44] | |
| Bamlanivimab plus Etesevimab | Recommended against the use for the treatment of COVID-19 or post-exposure prophylaxis. | [34, 45] | |
| Casirivimab plus Imdevimab |
• Recommended against the use for the treatment of COVID-19 or post-exposure prophylaxis. • Casirivimab plus Imdevimab are not effective against the Omicron variant and should not be used as prophylactic agents. |
[34, 46] | |
| Sotrovimab | Recommended against the use for the treatment of COVID-19 or post-exposure prophylaxis. | [34, 47] | |
| COVID-19 convalescent plasma | Recommended against the use for COVID-19 treatment. | [34, 48, 49] | |
| Cell-Based Therapy | Mesenchymal stem cells | Recommended against the use for COVID-19 treatment except in clinical trials. | [34, 50] |
| Immunomodulators | Colchicine | Recommended against the use for hospitalized and non-hospitalized COVID-19 patients. | [34, 51, 52] |
| Intravenous immunoglobulin (IVIG) | Recommended against the use for the treatment of patients with acute COVID-19 except in clinical trials. | [34, 52] | |
| Inhaled corticosteroids | Insufficient data available to recommend for or against the use in COVID-19 treatment. | [34, 53, 54] | |
| Fluvoxamine | Insufficient data available to recommend for or against the use in COVID-19 treatment. | [34, 39, 55] | |
| Granulocyte-Macrophage Colony-Stimulating Factor Inhibitors | Insufficient data available to recommend for or against the use in COVID-19 treatment. | [34, 56] | |
| Systemic corticosteroids: Dexamethasone | Recommended for the use in hospitalized COVID-19 patients based on disease severity. | [34, 57–59] | |
|
Inhaled corticosteroids: • Inhaled budesonide plus fluvoxamine • Inhaled fluticasone |
Insufficient data available to recommend for or against the use in COVID-19 treatment. | [60] | |
| IL-1 inhibitors: Anakinra | Insufficient data available to recommend for or against the use in COVID-19 treatment. | [34, 61] | |
| IL-6 inhibitors: Tocilizumab | Recommended for the use in hospitalized COVID-19 patients based on disease severity. | [34, 62, 63] | |
| Janus Kinase Inhibitors: Barictinib (or Tofacitinib) |
• Recommended for the use in hospitalized COVID-19 patients based on disease severity. • Recommended against the use of baricitinib plus tocilizumab except in clinical trials. |
[34, 64, 65] | |
| Bruton’s Tyrosine Kinase (BTK) Inhibitors (ibrutinib or acalabrutinib) | Recommended against the use for COVID-19 treatment except in clinical trials. | [34, 66] | |
| Siltuximab | Recommended against the use for COVID-19 treatment except in clinical trials. | [34, 67] | |
| Canakinumab | Recommended against the use for COVID-19 treatment except in clinical trials. | [34, 68] | |
| Antithrombotic Therapy | Anticoagulant therapy |
• Recommended against the use in non-hospitalized COVID-19 patients or continuing in those after hospital discharge. • Unfractionated heparin (UFH) and low molecular weight heparin (LMWH) are superior to oral anticoagulants in hospitalized patients. • Consider the therapeutic doses of heparin in hospitalized non-critically ill COVID-19 patients who receive low-flow oxygen. • Recommended the prophylactic doses of heparin in critically ill COVID-19 patients. • Recommended against the therapeutic dose of rivaroxaban for venous thromboembolism (VTE) prophylaxis or for prevention of COVID-19 disease progression. • Insufficient data available regarding the administration of the therapeutic dose of apixaban for VTE prophylaxis or for prevention of COVID-19 disease progression. • Recommended against the continuation of VTE prophylaxis in COVID-19 patients after hospital discharge |
[34, 69–71] |
| Antiplatelet therapy |
• Recommended against the use in non-hospitalized COVID-19 patients. • Those who are receiving antiplatelet or anticoagulant for an underlying disease should continue therapy during COVID-19 infection. |
[34, 72, 73] | |
| Supplements | Vitamin C | Insufficient data available to recommend for or against the use in COVID-19 treatment. | [34, 74, 75] |
| Zinc |
• Insufficient data available to recommend for or against the use in COVID-19 treatment. • Recommended against the administration of zinc over than recommended dietary allowance (RDA) for COVID-19 prophylaxis. |
[34, 75, 76] | |
| Vitamin D | Insufficient data available to recommend for or against the use in COVID-19 treatment. | [34, 77, 78] |