Mechanisms of action and adverse effects of the major therapeutic agents
in trial for COVID-19 therapeutics: review of literature
Abstract
Coronavirus disease 2019, an infectious viral disease caused by severe
acute respiratory syndrome coronavirus 2 has been declared a global
pandemic by World Health Organisation. The race to find an effective
cure for it is on. Most of the candidate drugs in various clinical
trials are being re-purposed but none has been approved as at date. It
is pertinent for the bedside physicians to understand the mechanisms of
action of these agents and their peculiar adverse effects so they are
properly guided on the risk/benefit of the drugs they choose in managing
COVID-19 patients. In this review, we aimed to review the mechanisms of
action and adverse effects of the major drugs in clinical trials for
COVID-19 therapeutics. Clinicaltrials.gov, the international clinical
trials platform of the WHO, the EU clinical trials register and the
Cochrane Central Register of Controlled Trials were searched for
registered clinical trials. Studies in therapeutic trials were
considered eligible for the work. Frequency table was made for the most
common trialled drugs and the mechanisms of actions and adverse effects
of the selected drugs were reviewed. 10 studies were selected for review
in a descending order of their frequency in different therapeutic trials
and these are ritonavir, lopinavir, chloroquine/hydroxychloroquine,
interferon, remdesvir, favipravir, umifenovir, darunavir, tocilizumab
and methylprednisolone. The bedside physicians need to understand the
mechanisms of action of these agents and their peculiar adverse effects
so they are properly guided on the risk/benefit of the drugs they choose
in managing COVID-19 patients.