Table 1.

Description of the activity, side effects and evidence on the use of the main drugs proposed for treatment of COVID19. When it comes to the evidence, there are no published paediatric case series, so the evidence presented here refers to the adult population.

	Pharmacological activity	Side effects	Evidence available at the time of this writing on its usefulness for management of COVID-19
Lopinavir/ritonavir	Used for treatment of acquired immunodeficiency syndrome. Demonstrated in vitro activity against coronavirus by inhibition of 3-chymotrypsin-like protease	Gastrointestinal complaints, nausea, vomiting, diarrhoea. It may cause pancreatitis, liver problems and disturbances of cardiac conduction	Case reports and retrospective studies on small samples. No established clinical evidence. Compassionate use in paediatric patients
Remdesivir	Activity against RNA viruses of the Coronaviridae and Flaviviridae families. Nucleotide analogue that could have activity against SARS-COV-2. It would hypothetically stop viral replication	Transaminase elevation and renal damage	Clinical trials under development. Adequate tolerance has been demonstrated, but the impact on disease course and outcomes cannot be predicted. Compassionate use in paediatric patients
Hydroxychloroquine	It is hypothesised that it may block viral entry by inhibiting the glycosylation of host cell surface receptors, proteolysis and the acidification required for entry to the cytosol. It could also have an immunomodulator effect by dampening production of cytokines, autophagy and lysosome activity in host cells	Common side effects include abdominal pain, diarrhoea, nausea and vomiting It may cause severe adverse events, such as cardiovascular damage, QT interval prolongation, haematologic disorders (haemolysis in case of glucose-6-phosphate dehydrogenase deficiency), hypoglycaemia, retinal toxicity, neuropsychiatric and central nervous system symptoms	There is no high-quality clinical evidence in COVID-19 patients. Only small case series. Clinical trials are currently underway
Macrolides (azithromycin)	Immunomodulatory effect. Several models have shown that it inhibits production and release of proinflammatory cytokines (IL-1, IL-6, IL-8 and TNF-α)	Thrombocytopenia, transient episodes of mild neutropenia, psychiatric disorders, dizziness/vertigo, seizures, headache, somnolence, hearing loss, palpitations, arrythmias (ventricular tachycardia), itching, rash, photosensitivity, oedema, urticaria and angioedema Rule out hypokalaemia and hypomagnesaemia, as they can cause conduction abnormalities. Rule out QT interval abnormalities, especially if administered in combination with other drugs	There is no evidence of its efficacy for treatment of COVID-19 alone or combined with hydroxychloroquine. Evidence from single case reports or small case series
Interferon alfa and beta	Cytokines involved in communication between leukocytes. They facilitate and strengthen both the innate immune response and the initiation of the adaptive immune response	Flu-like syndrome, headache, myalgia and changes in appetite. Haematologic changes as a late effect	Usually given in combination with antivirals. There is no evidence of it being beneficial against COVID-19 and it must be prescribed on a case-by-case basis
Steroid therapy	To reduce the inflammatory response. The side effects associated to this activity may slow down viral clearance or facilitate coinfection	Electrolyte imbalance, decreased white blood cell count, high blood pressure, behavioural changes, secondary infection, alterations in the hypothalamic-pituitary-adrenal axis, gastrointestinal bleeding	There is no evidence of its benefit. It must be prescribed on a case-by-case basis
Tocilizumab	Antibody against IL-6. This interleukin has been identified as playing a key role in the inflammatory pattern observed in the first patients described in Chinese case series	Immunosuppression and development of secondary infections. Haematological abnormalities, hepatotoxicity, gastrointestinal perforation and hypersensitivity reactions	Isolated clinical cases and small case series of patients without comparison or control groups. Clinical trials are under development.
Convalescent plasma	Antibodies collected from patients that recovered. Their administration would facilitate viral clearance	Allergic reactions and anaphylaxis. Capillary leak syndrome	Individualised use. Small case series have been described