Drugs used symptomatically:
There is no proper medicines available for COVID-19 treatment but the
medicines given to the patient is just to treat the symptoms or these
are given symptomatically also no vaccine is still present to avoid its
spread or to provide immunity to those who don’t have this infection
Moore, J.B et al (2020). So, the symptomatic treatment which is given to
the patients includes the drugs from different classes of drugs as; The
drugs as from anti-malarial class and those also used in rheumatoid
arthritis and systemic lupus erythmatosus (SLE) by decreasing the
activity as of the immune system as 500mg of Chloroquine given after
every 12 hours, along with200mg of hydroxychloroquine which is given
after every 12 hours were anticipated as having immunomodulatory role in
therapy Rosa, S.G et al (2020). Even though no any antiviral specific
treatments have been accepted, numerous approaches have been anticipated
like lopinavir/ritonavir as given 400/100 mg orally after every 12 hours
Lu, Q et al (2020).
Nonetheless, a current randomized, restricted trial as open-label has
verified that there is no advantage through treatment with
lopinavir/ritonavir when compared with the ordinary care. Preclinical
studies have recommended that the treatment with remdesivir (GS5734)
acting as an inhibitor of the RNA polymerase by means of an in vitro
action adjacent to the several RNA viruses Yang, H et al (2020),
counting Ebola might be effectual in favor of both prophylaxis as well
as therapy of HCoVs ( human coronaviruses) infections. It was used in
MERS-COV infection and alpha-interferon were also used Mizumoto, K et al
(2020). Noteworthy, in a trial that was non-randomized revealed that the
use of hydroxychloroquine was considerably related with the reduction in
the viral load in anticipation of viral desertion; furthermore, this
result was improved by the use of the antibiotics as macrolides (e.g.
azithromycin). Both In vitro as well as in vivo trials, certainly Shim,
E et al (2020), have revealed that macrolides antibiotics may possibly
alleviate inflammation as well as amend the immune system of the
individual. Specifically, these drugs possibly will stimulate the
decrease in the molecules as require for adhesion to the cell surface,
plummeting the production of the proinflammatory cytokines, invigorating
the process of phagocytosis through alveolar macrophages, as well as
prohibiting the activation as well as recruitment of the neutrophils
Kucharski, A.J et al (2020). Nevertheless, supplementary studies are
required in favor of prescribing as well as recommending the exploit of
azithromycin, unaccompanied or else coupled with supplementary drugs
like hydroxychloroquine, exterior of any antibacterial groups
Ludvigsson, J.F (2020). All over again, consideration ought to be
remunerated by means of the associated use of the hydroxychloroquine
along with azithromycin as alliance is able to escort to a
elevated peril of the prolongation of the QT interval as well as
arrhythmias. The use of Chloroquine can also encourage the prolongation
of the QT interval Goyal, P et al (2020). For the reason that the
patients of COVID-19 encompass an elevated prevalence of the venous
thromboembolism along with anticoagulant therapy is linked through
abridged ICU related death, it is recommended to the patients ought to
be given the thromboprophylaxis therapy as well. Furthermore, in the
case of identified thrombosis or thrombophilia, anticoagulation therapy
as enoxaparin 1 mg/kg BD (twice daily) is recommended Jiang, F et al
(2020). Another drug is use for the patients infected with COVID-19 and
those who were in severe condition as Tocilizumab (monoclonal antibody
and IL-6 blocker). A great number of the T lymphocytes as well as
mononuclear type’s macrophages are stimulated, and produce the cytokines
for instance IL-6 (interleukin-6), which attach to receptor of IL-6 on
target cells, and cause storm of cytokine as well as stern inflammatory
reactions in lungs as well as the supplementary tissues along with the
organs Zhang, L et al (2020). Tocilizumab, is( recombinant humanized
anti-human IL-6 receptor monoclonal antibody), can attach to the IL-6
receptor by means of elevated affinity, consequently, and it will
prevent the IL-6 itself as from fastening to its own receptors,
depiction as it is unable of the immune harm to the target cells, as
well as reducing the inflammatory reactions Wu, J et al (2020). Another
drug from the steroid group of drugs e.g. Dexamethasone which is a
artificial corticosteroid accepted by the FDA( food and drug
administration) as an immunosuppressor which is broad-spectrum in nature
as well as it is almost 30 times as active as well as having the
duration of action which is 2-3 days is also longer compared to
cortisone Tang, B et al (2020). This drug would perimeter the assembly
as well as detrimental consequences of the cytokines; although, it will
also restrain the defensive role of T cells along with obstruct the B
cells as of producing the antibodies, potentially it would leads to the
amplified plasma load of virus that will endure subsequent to the
survival of the patient from SARS Pan, L et al (2020). Furthermore,
dexamethasone would also obstruct the macrophages from reimbursement
secondary, hospital acquired infections. Consequently, dexamethasone may
be helpful in favor of the use of the drug for shorter duration in
rigorous and intubated patients of the COVID-19, however, it might be
absolute treacherous throughout resurgence as the virus will not only
endure, although, the body will be prohibited as of producing defensive
antibodies Han, C et al (2020). As a substitute, a pulse of the
intravenous (IV) dexamethasone possibly will be followed by giving the
triamcinolone which is nebulized which is 6 times as vigorous as
cortisone to contemplate in the lungs merely. The corticosteroids might
be recommended mutually with the natural flavonoid ( luteolin) since it
has antiviral as well as anti-inflammatory effects, particularly its
aptitude to restrain mast cells, which are the major cause of the
cytokines present in the lungs Soetikno, R et al (2020). A further study
exposed that the drug as ivermectin has shown its effectiveness in
COVID-19 patients and it is an anti-parasitic which have broad spectrum
drug. Ivermectin is FDA standard drug, recognized to encompass the
broad-spectrum antiviral action against many viruses in the in vitro
circumstances Mehta, P et al (2020). Current investigation on the
ivermectin in opposition to the SARS-CoV-2 in those as in vitro trials
exposed that it can restrain the replication of the virus. The distinct
treatment with this drug was proficient to lessen the virus replication
as up to the 5000-fold in the culture in 48h. Conversely, there is no
supplementary diminution was appeared as with auxiliary add to the time
period as when increased up to 72h Hollander, J.E et al (2020).
Furthermore, there is no toxicity of the drug with the use for either 48
or 72 hours. the Mechanism through which ivermectin showed response in
opposition to the CoV-19 virus is not recognized as well as it was
supposed to be functioning likewise as it show effect on other types of
viruses. It was recognized to restrain the nuclear importation of the
viral as well as the host proteins Zheng, Y et al (2020). The Integrase
protein as of the viruses along with the IMP (importin) α/β1 heterodimer
was accountable for those as nuclear import (IN) which additionally
promotes the infection. Because the majority of the RNA types of viruses
are reliant on the IMPα/β1 throughout the infection, Ivermectin show
effect on it along with inhibition of the importation by means of the
amplified antiviral effect Akalin, E et al (2020).