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. 2021 Jan 19;76(2):283-285.
doi: 10.1093/jac/dkaa442.

Treating COVID-19: are we missing out the window of opportunity?

Jeremiah Sundararaj Stanleyraj  1 , Nandini Sethuraman  2 , Rajesh Gupta  3 , Sohanlal Thiruvoth  4 , Manisha Gupta  5 , Akihide Ryo  1
Affiliations

Treating COVID-19: are we missing out the window of opportunity?

Jeremiah Sundararaj Stanleyraj et al. J Antimicrob Chemother. .

Abstract

Severe COVID-19 is a biphasic illness, with an initial viral replication phase, followed by a cascade of inflammatory events. Progression to severe disease is predominantly a function of the inflammatory cascade, rather than viral replication per se. This understanding can be effectively translated to changing our approach in managing the disease. The natural course of disease offers us separate windows of specific time intervals to administer either antiviral or immunomodulatory therapy. Instituting the right attack at the right time would maximize the benefit of treatment. This concept must also be factored into studies that assess the efficacy of antivirals and immunomodulatory agents against COVID-19.

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Figures

Figure 1.
Figure 1.
Window of opportunity for managing COVID-19. Initial viraemia subsides early in the disease, followed by a rise of inflammatory markers, which subsides in mild illness but spikes in severe illness. This figure appears in colour in the online version of JAC and in black and white in the print version of JAC.
See this image and copyright information in PMC

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