Potential Effects of Adjuvant Treatments on Coronavirus Disease 2019 (COVID-19)
Adjuvant Treatments and COVID-19
Abstract
At present, there are no effective treatments for coronavirus disease 2019 (COVID-19) and the therapeutic interventions are limited to supportive care, varying from symptomatic management to critical care support. Corticoids are administered to reduce host inflammatory responses in the lungs. The potential harm and the lack of proven benefit of corticosteroids cautions against their routine administration in COVID-19 patients outside the Randomized Clinical Trials (RCTs), with an exception of a concomitant indication, such as a refractory shock. The amplified immune response and Cytokine Release Syndrome (CRS) are known to cause significant organ damage (lungs), providing a rationale for the use of monoclonal Antibody (mAb). Hyperimmune Immunoglobulins (Igs) from the recovered patients may also assist with improving the immune response and virus clearance. Human Normal Immunoglobulins (HNIGs) can be administered in the early seven to ten days of infection, during peak viremia or in the absence of a primary immune response. Ultimately, a vaccine could provide a potential permanent strategy, creating protective immunity for people and preventing future outbreaks.
How to cite this article:
Tagaev T, Uulu MS, Kyzy AE, Yethindra V, Mainazarova E, Mamatov S et al. Potential Effects of Adjuvant Treatments on Coronavirus Disease 2019 (COVID-19). J Commun Dis 2020; 52(2): 74-77.
DOI: https://doi.org/10.24321/0019.5138.202022
References
Yethindra V. Role of GS-5734 (Remdesivir) in inhibiting SARS-CoV and MERS-CoV: The expected role of GS-
(Remdesivir) in COVID-19 (2019-nCoV) - VYTR hypothesis. Int J Res Pharm Sci 2020; 11: 1-6. DOI.
org/10.26452/ijrps.v11iSPL1.1973.
Stockman LJ, Bellamy R, Garner P. SARS: systematic review of treatment effects. PLoS Med 2006; 3(9):
e343. DOI: 10.1371/journal.pmed.0030343.
Arabi YM, Mandourah Y, Al-Hameed F, Sindi AA, Almekhlafi GA, Hussein MA et al . Saudi Critical Care
Trial Group. Corticosteroid therapy for critically ill patients with Middle East respiratory syndrome. Am
J Respir Crit Care Med 2018; 197(6): 757-767.
Ni YN, Chen G, Sun J, Liang BM, Liang ZA. The effect of corticosteroids on mortality of patients with influenza
pneumonia: a systematic review and meta-analysis. Crit Care 2019; 23(1): 99. DOI: 10.1186/s13054-019-2395-8.
Russell CD, Millar JE, Baillie JK. Clinical evidence does not support corticosteroid treatment for 2019-nCoV
lung injury. Lancet 2020; 395(10223): 473-475.
Wu C, Chen X, Cai Y et al. Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in
Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China. JAMA Intern Med 2020;e200994.
doi:10.1001/jamainternmed.2020.0994.
Wang C, Li W, Drabek D, Okba NMA, Haperen RV, Osterhaus ADME et al. A human monoclonal antibody
blocking SARS-CoV-2 infection. Nat Commun 2020; 11: 2251. DOi: 10.1038/s41467-020-16256-y.
Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ. HLH Across Speciality Collaboration,
UK. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet 2020; 395(10229):
-1034.
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z et al. Clinical course and risk factors for mortality of adult in patients with
COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020; 395(10229): 1054-1062.
Xu X, Han M, Li T, Sun W, Wang D, Fuet B et al. Effective treatment of severe COVID-19 patients with
tocilizumab. Proc Natl Acad Sci U S A 2020; 117(20): 10970-10975.
Sanofi. Sanofi and Regeneron begin global Kevzara (sarilumab) clinical trial program in patients with severe
COVID-19 [news release]. Published March 16, 2020. Accessed March 18, 2020. http://www.news.sanofi.
us/2020-03-16-Sanofi-andRegeneron-begin-global-Kevzara-R-sarilumabclinical-trial-program-in-patientswith-
severeCOVID-19.
ClinicalTrials.gov. Accessed March 18, 2020. https://clinicaltrials.gov/.
Soo YO, Cheng Y, Wong R, Hui DS, Lee CK, Tsang KKS, et al. Retrospective comparison of convalescent
plasma with continuing high-dose methylprednisolone treatment in SARS patients. Clin Micro Biol Infect 2004;
(7): 676-678.
Arabi Y, Balkhy H, Hajeer AH, Bouchama A, Hayden FG, Al-Omari A et al. Feasibility, safety, clinical, and
laboratory effects of convalescent plasma therapyfor patients with Middle East respiratory syndrome
coronavirus infection: a study protocol. Springerplus 2015; 4: 709. DOI: 10.1186/s40064-015-1490-9.
Hung IF, To KK, Lee CK, Lee KL, Chan K, Yan WW et al. Convalescent plasma treatment reduced mortality in
patients with severe pandemic influenza A (H1N1) 2009 virus infection. Clin Infect Dis 2011; 52(4): 447-456.
Mair-Jenkins J, Saavedra-Campos M, Baillie JK, Cleary P, Khaw FM, Lim WS et al. Convalescent Plasma Study
Group. The effectiveness of convalescent plasma and hyperimmune immunoglobulin for the treatment of
severe acute respiratory infections of viral etiology: a systematic review and exploratory meta-analysis. J
Infect Dis 2015; 211(1): 80-90.
Shen C, Wang Z, Zhao F, Yang Y, Li J, Yuan J et al. Treatment of 5 critically ill patients with COVID-19 with
convalescent plasma. JAMA 2020; 323(16): 1582-1589.
Cao W, Liu X, Bai T, Fan H, Hong K, Song H et al. Highdose intravenous immunoglobulin as a therapeutic
option for deteriorating patients with coronavirus disease 2019. Open Forum Infect Dis 2020; 7(3):
ofaa102. DOI: 10.1093/ofid/ofaa102.
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