The use of pharmacological therapies in hospitalized COVID-19 patients– A literature review

Abstract

Introduction: A number of pharmacological therapies have been reported to be used in the treatment of hospitalized COVID-19 patients outside a clinical trial setting.

Aim: To summarize published data on the use of pharmacological therapies in the real-world setting among hospitalized COVID-19 patients during the early phase of the pandemic.

Methods: A targeted review of the literature published before 21 August 2020 reporting the use of pharmacological therapies in hospitalized patients was undertaken using the PubMed/MEDLINE database. Only observational studies reporting data in the real-world setting were included.

Results: Antivirals (e.g., lopinavir/ritonavir, arbidol, ribavirin, umifenovir, ganciclovir, oseltamivir), chloroquine/hydroxychloroquine, antibiotics (e.g., azithromycin), antifungals, corticosteroids, tocilizumab, immunoglobulin, and interferon have been reported to be used as pharmacological treatments in hospitalized patients early in the pandemic, with antivirals used most often followed by hydroxychloroquine and antibiotics. Older patients were more often treated with hydroxychloroquine, antibiotics, corticosteroids, and immunoglobulin as compared to younger patients. Arbidol, corticosteroids, and antibiotics were used more frequently in patients with pre-existing COPD or asthma.

Conclusions: A variety of pharmacological therapies were trialed in the treatment of hospitalized patients early in the pandemic when little to no evidence base existed. Antivirals, hydroxychloroquine and antibiotics were used most frequently. The use of pharmacological therapies varied by patient characteristics such as age and comorbidities.

Funding: GSK [study 214627]