Description:
Background: The effective responses of both innate and adaptive immunity are crucial in
combating novel coronavirus-2 infection. An excessive response may lead to cytokine storm,
which is a challenging problem in therapeutic strategies.
Methods: A systematic review was carried out by searching Ovid MEDLINE, PubMed,
Google Scholar, and Cochrane library databases from inception, for anti-inflammatory and
immunomodulatory drugs against coronavirus disease 2019 (COVID-19).
Results: The results of the effectiveness of Hydroxychloroquine are just like a sinusoidal diagram
and in a state of ambiguity. Thalidomide was effective in some cases but has not yet been proven.
Low-dose Corticosteroids may be effective in the early stages of the illness as a bridge. There is
no evidence of benefits or adverse outcomes for the use of non-steroidal anti-inflammatory drugs
and Cyclosporine-A. In some critically ill patients, Interleukin-6 (IL-6) and IL-1 blockers and to
some extent, Tumor-Necrosis-Factor-? and Janus-Kinase inhibitors are useful. Finally, high-dose
intravenous immunoglobulin reversed the deterioration of patients in most trials.
Conclusion: One strategy behind the treatments for COVID-19 is based on breaking the cytokine
storm. Although avoiding the suppression of anti-viral immunity is crucial by choosing the
weaker and more selective anti-inflammatories, some strategies are kept for hyper-inflammatory
situations. Scheduling of treatment is also important. Although low-dose steroids may be effective
in the early stages of the illness, “Tocilizumab” is more effective in severe situations, when the
IL-6 level is high and other drugs are ineffective. Therefore, consideration should be given to each
patient separately
URL:
http://103.158.96.210:88/web_repository/uploads/ps-27-S13.pdf
Type:
Journal
Document:
Diploma III Farmasi
Date:
23-06-2024
Author:
Reza Sinaei