Scientific evidence in the COVID-19 treatment: A comprehensive review

Table 1 Coronavirus disease 2019 treatments

Drug	Mechanism of action	Recommendation	Posology	Benefits
Remdesivir1	RNA replication inhibition	Hospitalized patients in the first 10 d of infection requiring supplementary oxygen, without mechanical ventilation or extracorporeal oxygenation	Loading dose of 200 mg, followed by 100 mg daily for 5 d	Reduction in recovery time compared to placebo (10 d vs 15 d)
Corticosteroids1	Anti-inflammatory and immunosuppressive effects	Hospitalized patients requiring oxygen therapy. Also beneficial in patients with higher requirements of respiratory support	Dexamethasone 6 mg daily for 10 d	Reduction of mortality at 28 d. Decrease the risk of IMV and days of IMV
Tocilizumab1	Antagonist of IL-6 receptor. Immunomodulatory effect	Hospitalized patients with hypoxia and elevated acute phase reactants	8 mg/kg in a single dose (maximum of 600 mg). A second dose might be administrated if lack of effect	Reduction of mortality at 28 d. Reduce progression to IMV
Anakinra2	Antagonist of IL-1 receptor. Immunomodulatory effect	Not clear recommendations. Hospitalized patients with hypoxia and elevated acute phase reactants	-	Some data show some effect on clinical improvement in patients with NIMV requirements.
Sarilumab2	Antagonist of IL-6 receptor. Immunomodulatory effect	Not clear recommendations. Hospitalized patients with hypoxia and elevated acute phase reactants	-	It might reduce mortality in critical patients (unclear data)
Bariticinib2	Janus kinase (JAK) 1/2 inhibitor. In-vitro activity against SARS-CoV-2, given its inhibitory effect on cytokine release and its inhibition of virus entry into pneumocytes	Not clear recommendations. Hospitalized patients with moderate-severe COVID-19 infection	-	In combination with corticosteroid, it improves SpO2/FiO2
Colchicine2	Lipid soluble alkaloid, with anti-inflammatory effect	Not clear recommendations. Non-hospitalized patients with COVID-19	-	Some data show reduction of mortality and hospitalization in patients with mild infection.
Otilimab2	Monoclonal antibody, anti-granulocyte macrophage colony-stimulating factor	Not clear recommendations. Hospitalized patients with severe disease	-	Might have beneficial effects in elderly patients with severe disease
Plitidepsin2	Inhibition of eef1a, reduce viral replication	More studies needed, not clear recommendations	-	-
Hydroxychloroquine3	RNA replication inhibitor	Not recommended
Azithromycin3	Immunomodulatory effect	Not recommended
Lopinavir-Ritonavir3	Protease inhibitor.	Not recommended	-	-
Hyperimmune plasma3	Convalescent plasma with active antibodies against SARS-CoV-2	Not recommended	-	-

¹Recommended ones.

²Need more evidence.

³Not recommended treatments. COVID-19: Coronavirus disease 2019; SARS-CoV-2: Severe acute respiratory syndrome coronavirus-2; IMV: Invasive mechanical ventilation.