Several medicinal products and vaccines have been discovered and some are undergoing clinical trials to evaluate their safety and efficacy to cure or prevent Covid-19. Some of the commonly used treatment medications for Covid-19 are the antiviral nucleotide analogue remdesivir, corticosteroids, monoclonal antibodies against interleukin-6 (IL-6) (an immune system component), systemic interferons, other immune modulators, and monoclonal antibodies against SARS-CoV-2. Yet now conducted and completed clinical trials for COVID-19 treatments are mainly focused on adult patients. Therefore limited information is available on the pediatric treatment of COVID-19. Following are different medications that showed efficacy against Covid-19:
Antiviral
Remdesivir
The European Medicines Agency (EMA) granted remdesivir a conditional marketing authorization to treat adult COVID-19 patients with pneumonia requiring supplemental oxygen. The U.S. Food and Drug Administration (FDA) has advised not to use combination therapy of remdesivir with hydroxychloroquine.
Favipiravir
Favipiravir is an orally administered antiviral drug that inhibits the viral RNA polymerase that was initially used for influenza. But During the COVID-19 pandemic, different clinical trials reported that Favipiravir could reduce viral load and clinical cure was shorter than standard treatment for mild to moderate COVID-19 cases.
Molnupiravir
This is another oral anti-viral medication that reduces time to achieve negativity of infectious conditions of COVID-19 patients. Molnupiravir is active against RNA viruses.
Steroids
Systemic corticosteroids
Dexamethasone is given in systematic circulation can significantly reduce 28-day mortality, specifically among critically ill COVID-19 patients who are under mechanical ventilation. However, no evidence supports that this can help patients who did not require oxygen. A recent clinical trial report suggested that a combination of intravenous immunoglobulins (IVIG) and methylprednisolone could provide more favorable disease outcomes than treatment with IVIG alone.
Budesonide
Inhalation of budesonide in adult COVID-19 patients with mild symptoms could reduce the frequency of urgent care visits (3%) compared with the standard care arm (15%).
Immunomodulatory monoclonal antibodies
Tocilizumab is a monoclonal antibody that inhibits the pro-inflammatory action of interleukin 6. Tocilizumab in combination with standard of care in patients with progressive severe or critical COVID-19 can reduce relative risk and mortality rate. A research study report stated that administration of both tocilizumab and sarilumab (another monoclonal antibody with anti-IL-6 activity) within 24 hours to the COVID-19 patient who has been admitted to an intensive care unit can reduce the relative risk of death by 24% in combination with standard care.
Baricitinib that selectively inhibits Janus kinases (JAKs) 1 and 2 can reduce median time to recovery in combination with remdesivir.
Monoclonal antibodies against components of SARS-CoV-2
Bamlanivimab is a type of monoclonal antibody that acts against components of SARS-CoV-2 helps to a significant decline in viral loads and reduces the requirement of medical attention.
COVID-19 convalescent plasma (CCP) therapy
The administration of plasma with antibodies collected from patients who have recovered from COVID-19 is also considered a prophylactic and therapeutic option. But research results do not show consistent therapeutic benefits and that causes a doubtful treatment option for COVID-19.
Other therapeutic agents
Some other recommended medicines for COVID-19 treatment are Colchicine, Sargramostim, Hydroxychloroquine/chloroquine, Lopinavir/ritonavir, and Ivermectin. But the efficacy of these medications is not completely tested through randomized clinical trials.
Vaccination against COVID-19
In India, two locally-made vaccines, Covishield and Covaxin are available. The Serum Institute of India is manufactured Covishield under license from AstraZeneca. Bharat Biotech makes Covaxin. Although vaccination drive has already started in India. But to complete this vaccination drive takes time more than the estimated time. However, apart from Covishield and Covaxin, The Sputnik V vaccine also got approval to use in the Indian population. Russia supplies this vaccine to India. But soon, this vaccine is also being produced locally.
Following are the CDC recommended COVID-19 vaccines:
References
https://www.ecdc.europa.eu/en/covid-19/latest-evidence/treatment
https://www.bbc.com/news/world-asia-india-55571793
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines.html
