Table 2.
Mechanism, advantages, and limitations for the treatments in this study
| Mechanism | Advantages | Limitations | |
|---|---|---|---|
| Remdesivir | 1. Interrupting the transcription of the virus and inhibiting RdRp enzyme activity | 1. Inhibiting RNA virus replication in cells without obvious cytotoxicity in vitro | 1. Lack of phase I and II clinical data against 2019 novel coronavirus |
| 2. A higher competitive affinity to RdRp enzyme than adenosine triphosphate | 2. The possible adverse reactions caused at this dose (100 mg except for the first day of 200 mg) due to differences in ethnicity | ||
| 3. A complete data on human pharmacokinetics and safety for infection of Ebola virus | |||
| Ribavirin | 1. Interfering with viral transcription events and hindering the synthesis of ribonucleoproteins | 1. A broad‐spectrum nucleoside antiviral drug | 1. Major side effect: hemolytic anemia |
| 2. Low‐cost | 2. Lack of domestic phase I and II clinical data against 2019 novel coronavirus | ||
| 3. Insufficient evidence of clinical effects after being applied to SARS‐infected patients | |||
| Chloroquine | 1. Reducing the infectivity of virions by increasing the endosomal pH | 1. A potent inhibitor of SARS‐CoV in cell culture | 1. Limited to the cell culture and the animal models |
| 2. Interfere with terminal glycosylation of ACE2 | 2. Recommended by experts in China based on clinical trials from more than 10 hospitals | 2. Potential adverse drug reactions such as cardiotoxicity and irreversible retinopathy should not be ignored | |
| 3. Mediating the inflammatory complications of several viral diseases | 3. Attentions of the contraindications and precautions | ||
| 4. Inhibiting viral replication in vitro for SARS‐CoV | 4. Lethal dose may occur because of chloroquine accumulation | ||
| Corticosteroids | 1. Anti‐inflammatory action and immunomodulatory effect | 1. Inhibiting the production of inflammatory cytokines which may cause a cytokine storm | 1. Delaying viral clearance |
| 2. Supplement with endogenous cortisol deficiency | 2. Side effect: avascular necrosis, psychosis, diabetes, secondary infection | ||
| 3. Without evidence on the antiviral effect of corticosteroids | |||
| Artificial liver system | 1. Plasma exchange and continuous venovenous hemofiltration | 1. Removing inflammatory cytokines to interrupt cytokine storm | 1. Related complications: hemorrhage, coagulation, hypotension, secondary infection, allergic reaction, and disequilibrium syndrome |
| 2. Supplement with the necessary material to create good conditions against infection | 2. High cost and requirement for a specialist multidisciplinary team | ||
| 3. Improving the internal environment to wait for generating antibody | |||
| ECMO | 1. Cardiac and respiratory support | 1. Reduce ventilator parameters and avoid ventilator‐related pressure and volume injuries | 1. Related accidents and complications, including bleeding, infection, hemolysis, thrombosis, limb ischemia, multiple organ failure, and even life‐threatening in severe cases |
| 2. Improving oxygenation and ventilation of patients with H7N9‐induced severe ARDS | 2. High manufacturing cost, high operation cost and requirement for a specialist multidisciplinary team |
Abbreviations: ACE2, angiotensin‐converting enzyme 2; ECMO, extracorporeal membrane oxygenation; RdRp, RNA‐dependent RNA polymerase; SARS‐CoV, severe acute respiratory syndrome‐related coronavirus.