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Review
. 2021 Jan 22;18(3):955.
doi: 10.3390/ijerph18030955.

The History, Efficacy, and Safety of Potential Therapeutics: A Narrative Overview of the Complex Life of COVID-19

Farah Daou  1 , Gretta Abou-Sleymane  1 , Danielle A Badro  1   2 , Nagham Khanafer  3   4 , Mansour Tobaiqy  5 , Achraf Al Faraj  1
Affiliations
Review

The History, Efficacy, and Safety of Potential Therapeutics: A Narrative Overview of the Complex Life of COVID-19

Farah Daou et al. Int J Environ Res Public Health. .

Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic posed a serious public health concern and started a race against time for researchers to discover an effective and safe therapy for coronavirus disease 2019 (COVID-19), the disease caused by SARS-CoV-2. This review aims to describe the history, efficacy, and safety of five potential therapeutics for COVID-19, remdesivir, favipiravir, hydroxychloroquine, tocilizumab, and convalescent plasma. A literature review was conducted through October 2020 to identify published studies evaluating the efficacy and safety of these five potential therapeutics. Clinical improvement was used to assess the efficacy, while reported withdrawals from study participation and adverse events were used to evaluate the safety. In total, 95 clinical studies (6 interventional and 89 observational studies) were obtained, of which 42 were included in this review. The evaluation of the efficacy and safety profiles is challenging due to the limitations of the clinical studies on one hand, and the limited number of randomized controlled trials (RCTs) on the other. Moreover, there was insufficient evidence to support repurposing remdesivir, favipiravir, and tocilizumab for COVID-19.

Keywords: COVID-19; efficacy; safety; therapeutics.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Number of studies retrieved for remdesivir, favipiravir, hydroxychloroquine, tocilizumab, and convalescent plasma in coronavirus disease 2019 (COVID-19) patients as of 1 October 2020. RCT: randomized controlled trial.
Figure 2
Figure 2
Timelines of remdesivir (a) and favipiravir (b) from discovery to repurposing for COVID-19. EBOV: Ebola virus; WHO: World Health Organization; FDA: Food and Drug Administration; EUA: Emergency Use Authorization.
Figure 3
Figure 3
Timeline of hydroxychloroquine from FDA approval to repurposing for COVID-19.
Figure 4
Figure 4
Timelines of tocilizumab (a) and convalescent plasma (b) from discovery to repurposing for COVID-19.
Figure 5
Figure 5
Summary of adverse events associated with the administration of the five potential therapeutics in COVID-19 patients.
See this image and copyright information in PMC

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