The information is based on current knowledge of COVID-19 and will be updated as more scientific evidence is released. 

Potential treatment options

1. Hydroxychloroquine

  • Hydroxychloroquine is used against SARS-CoV-2 in two folds: it decreases viral replication through T-cell suppression and it inhibits the immune response (cytokine storm) caused by the viral infection. 

  • There is some evidence to suggest taking Azithromycin on top of Hydroxychloroquine may be effective against severe bacterial respiratory infections that arise from SARS-CoV-2, but take this information with caution because the study was not well powered. 

  • Note that current dosing is based on previous clinical experience, and adverse effects may occur. Current clinical trials are underway. 

Source:

Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial

Efficacy of hydroxychloroquine in patients with COVID-19: results of a randomized clinical trial

2. Remdesivir

  • Remdesivir is an investigational drug that interferes with virus replication by inhibiting viral RNA polymerase; it has shown to be effective against SARS (severe acute respiratory syndrome) and MERS (middle eastern respiratory syndrome) in the past. 

  • Preclinical data suggests that it may have potent activity against SARS-CoV-2, although human data regarding efficacy and safety is limited. 

  • Remdesivir can be obtained for hospitalized patients with COVID-19 in the United States through clinical trials and Gilead's expanded access program (available soon). 

Think you might be eligible or interested? Here are some ways you can get it: NIH sponsored clinical trial in COVID-19 patients, phase III clinical trial for severe disease presentation, Gilead expanded access programphase III clinical trial for moderate disease presentation

 

3. Lopinavir/Ritonavir (Kaletra)

  • Kaletra is a retroantiviral medication that has reduced viral loads and risk of adverse events in patients with SARS and MERS. 

  • One randomized controlled trial involving patients in Wuhan found that Kaletra did not decrease viral load, improve clinical improvement, or reduce mortality.

Source: A Trial of Lopinavir–Ritonavir in Adults Hospitalized with Severe Covid-19

4. Tocilizumab (Actemra)

  • Tocilizumab is an immunosuppressive drug that may be helpful against COVID-19 patients with cytokine storm, which is an elevated immune response to foreign particles, such as the SARS-CoV-2 virus. 

  • According to the current Novel Coronavirus Pneumonia Diagnosis and Treatment Plan, Tocilizumab is recommended for patients with elevated biomarkers for immune response as well as extensive/bilateral lung disease. 

  • Note that because secondary bacterial infections are common in patients with COVID-19, patients on Tocilizumab will need to be monitored carefully.

  • Tocilizumab is currently undergoing phase III clinical trials in the US and is being used in China for COVID-19 patients

Source: Novel Coronavirus Pneumonia Diagnosis and Treatment Plan

5. Zinc 

  • Zinc is a potent inhibitor of RNA viruses in vitro, such as the SARS-CoV-2, by interfering with viral protein processing; this means that virus parts will have a harder time assembling into mature viruses.

  • Zinc-ionophores such as Hydroxychloroquine will increase the absorption of Zinc into the body and may lead to cardiovascular side effects due to a higher level of positive ions in the body. 

Source: Zn2+ Inhibits Coronavirus and Arterivirus RNA Polymerase Activity In Vitro and Zinc Ionophores Block the Replication of These Viruses in Cell Culture

6. Ivermectin

  • Ivermectin inhibits the replication of SARS-CoV-2 in vitro, in theory, by inhibiting the transport of viral proteins 

  • Ivermectin is a FDA approved medication used against parasites, but was found to have broad range antiviral activity. 

Source: The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro

7. Convalescent Plasma

  • Convalescent plasma uses antibodies from those recovered to treat COVID-19 patients, which has seen success in the past in SARS, MERS, and H1N1 epidemics

  • Investigators will be studying the use of convalescent plasma in clinical trials soon

Source: FDA guideline on Convalescent Plasma

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