Therapeutic Management of Coronavirus Disease 2019 (COVID-19): A Systematic Review and Treatment Algorithm
Rafat Zreiq
Department of Public Health, College of Public Health and Health Informatics, University of Ha'il, Ha'il, Saudi Arabia. and Molecular Diagnostic and Personalised Therapeutics Unit, University of Ha'il, Ha'il, Kingdom of Saudi Arabia.
Najoua Haouas
Laboratory of Medical and Molecular Parasitology-Mycology LP3M (Code LR12ES08), Department of Clinical Biology, Faculty of Pharmacy, University of Monastir, Tunisia.
Asma M. Khemakhem
Department of Biology, Faculty of Science of Sfax, University of Sfax, Sfax, Tunisia.
Rawan M. Obeidat
Department of Public Health, College of Public Health and Health Informatics, University of Ha'il, Ha'il, Saudi Arabia.
Reem M. Ali
Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences, University of Ha'il, Ha'il, Kingdom of Saudi Arabia.
Asma Ayyed AL- Shammary
Department of Public Health, College of Public Health and Health Informatics, University of Ha'il, Ha'il, Saudi Arabia. and Department of Biology, Faculty of Science, University of Ha'il, Ha'il, Saudi Arabia.
Bandar Alsaif
Department of Public Health, College of Public Health and Health Informatics, University of Ha'il, Ha'il, Saudi Arabia.
Fahad D. Algahtani *
Department of Public Health, College of Public Health and Health Informatics, University of Ha'il, Ha'il, Saudi Arabia.
*Author to whom correspondence should be addressed.
Abstract
Coronavirus disease 2019 (COVID-19) is emerging contagious pneumonia due to the new Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). It initially appeared in Wuhan China in December 2019 then rapidly spread worldwide and became a pandemic. For the time being, there is no specific therapeutic treatment for this disease. Herein, the "state-of-the-art" of treatment modalities was systematically reviewed and ultimately a practical therapeutic algorithm for the COVID-19 management was proposed. The systematic review was performed by using published articles retrieved from Science Direct, MEDLINE, and Scopus databases concerning this topic. Among 1060 articles collected from the different databases, 19 publications were studied in-depth and incorporated in this review. The most three frequently used medications for the treatment of COVID-19 was: the available anti-viral drugs (n= 9), the antimalarial hydroxychloroquine or chloroquine (n = 8), and the passive antibody transfer therapy (n = 2). Among all treatment modalities, antimalarial hydroxychloroquine ranked the highest cure rate. Therefore, this drug is considered as the first‐line of COVID-19 treatment. The second‐line treatment includes the lopinavir/ritonavir drugs combined with interferon β-1b and ribavirin. Finally, the third‐line treatments include the remdesivir drug and passive antibody transfer therapy. However, our review emphasis the urgent need for adequately designed randomized controlled trials, enabling a more significant comparison between the most used treatment modalities.
Keywords: COVID-19, therapeutic management, treatment algorithm, Chloroquine, hydroxychloroquine.