Introduction
Since the initial outbreak of the coronavirus infection, limited clinical evidence has been a reason for repurposing drugs with overlooked or overestimated effectiveness. The specific elements of different studies that have affected their outcomes are design defects, sample sizes, different circumstances of treatment initiation, and other similar issues. Thus, many scientists worldwide encourage further research on the subject and conduct more clinical trials to extend the range of available therapeutic options for those who have coronavirus disease. For these purposes, a group of researchers from the National Cheng Kung University in Taiwan has reviewed the effective treatment methods for COVID-19 based on the existing scientific evidence. The authors aim to fill the pharmacotherapy gap for coronavirus by sharing the information among global research institutions. The researchers analyze different medications on the grounds of clinical and scientific support and give recommendations on whether those drugs can be used for treating COVID-19.
Analysis
The research authors have examined several studies on various treatment options for the coronavirus disease, including six specific drugs, convalescent plasma, traditional Chinese medicine, and vaccines in development. The drugs involved in the study are remdesivir, lopinavir-ritonavir, favipiravir, ribavirin, interferon, chloroquine, hydroxychloroquine, and interleukin-6 inhibitors such as tocilizumab (Chen et al., 2020). The researchers have examined several studies on each treatment option presented, but the primary outcomes in different trials were also different. For instance, clinical experiments with tocilizumab for adult patients in France have resulted in patients’ deaths or ICU admissions. The trials of the same drug in Italy led to survival and clinical improvements at 28 days, while the research in the United States did not achieve any outcome at all (Chen et al., 2020). In other words, there is a high chance that some of the trials were conducted incorrectly, or that the current scientific knowledge on the observed medications is insufficient to achieve precise results.
Many preparations were only subjected to clinical trials in single studies, which may not be enough based on the assumption that different experiments achieve different primary outcomes, as mentioned previously. For example, the usage of favipiravir in adults with pneumonia caused by coronavirus infection has shown a clinical recovery rate on the seventh day in 71.4% of cases (as cited in Chen et al., 2020, p. 1788). The researchers also state that favipiravir has positively influenced the pyrexia resolution time and cough, but the corresponding data comes from a single clinical investigation in China (Chen et al., 2020). Although the authors of the review have examined many studies on the topic, not all of them contained results of actual clinical trials, providing much theoretical information based on scientific knowledge. The divergence of primary outcomes of other medications in different trials suggests that the results of a single study do not provide sufficient evidence for an adequate evaluation of a specific drug.
Nonetheless, the authors of the review make their conclusions about each of the examined drugs and provide recommendations related to the treatment options for COVID-19. The researchers suggest further tests and trials of most medications, including remdesivir and favipiravir, saying their potential is not wholly explored yet. They specifically state that lopinavir and interferon trials are worth conducting as these drugs have proved their clinical effectiveness, and further research might help to use them for treating coronavirus (Chen et al., 2020). However, the researchers have expressed their uncertainty about particular medications, doubting the efficacy of interleukin inhibitors and convalescent plasma and explaining the necessity for scientific validation of traditional Chinese medicine. They also recommend using chloroquine and hydroxychloroquine with caution, as they have led to arrhythmia and cardiac death in certain cases (Chen et al., 2020). Overall, the authors suggest that proper coronavirus treatment depends on further research and vaccines in development.
Discussion
The study under discussion has several significant implications that can impact the development of therapeutic options for coronavirus. Much research is required to examine the potential effectiveness of the drugs observed and the correlated risks. Although coronavirus has been actively explored since the initial outbreak, the researchers provide evidence that many proposed medications may be ineffective or even dangerous. They believe that the most promising of currently existing strategies is the development of COVID-19 vaccines that can support anti-viral agents in ending the pandemic (Chen et al., 2020). The data provided in the study can significantly contribute to the current knowledge of coronavirus pharmacotherapy, improving patient outcomes and helping end the pandemic.
Conclusion
Furthermore, the researchers recommend focusing on the early stage of COVID-19 in patients. They believe that “the inhibition of viral proliferation in the early stage of COVID-19 can prevent subsequent severe complications” (Chen et al., 2020, p. 1790). In that sense, the development of vaccines seems even more reasonable as they are intended to prevent the disease from infecting one’s body. Thus, multidisciplinary cooperation among clinicians, chemists, and structural biologists is recommended to enhance the research process and find the most efficient treatment options for coronavirus as soon as possible.
Reference
Chen, P. L., Lee, N. Y., Cia, C. T., Ko, W. C., & Hsueh, P. R. (2020). A review of treatment of coronavirus disease 2019 (COVID-19): Therapeutic repurposing and unmet clinical needs. Frontiers in pharmacology, 11, 1782-1793. Web.