Abordaje terapéutico en pacientes con infección por coronavirus SARS-COV-2

Resumo

COVID-19 is representing a challenge for public health systems due to the high morbidity and mortality in the general population. The responsible pathogen is a coronavirus (SARS-COVID-2) and there were no known treatments even when previous experience with other coronavirus responsible for respiratory diseases (SARSCoV, MERS-CoV) was considered. Knowledge about the disease has established the need for administering not only effective antiviral therapy but also drugs with anti-inflammatory/immunomodulatory activity to treat other symptoms appearing in a second phase of the disease. Actually, no drug has shown to be efficient against coronavirus in humans, although in vitro several of them has shown anti-COVID activity (lopinavir/ritonavir; chloroquine,/hydroxychloroquine; azithromycin, betaferon). There are several clinical trials going on with remdesivir showing promising results. Anti-inflammatory/immunomodulatory treatment has been also widely explored. Short courses of low dose glucocorticoids have shown a reduction in mortality in an aleatorized clinical trial, although the results are not conclusive. Tociluzumab has been widely used with positivity data in observational studies but clinical trials results are still pending. In a rapidly evolving scenario, many clinical trials on COVID treatment covering drug treatments and other therapeutic strategies are on-going and will likely provide, during the next months, established therapeutic protocols for these patients.