Most viral infections have limited treatment options available and the same holds for COVID-19, its causative agent being the SARS-CoV-2 virus. Drugs used in the past against Severe Acute Respiratory Syndrome (SARS) or Middle East Respiratory Syndrome (MERS) viruses, which belong to the same family of viruses as the novel Coronavirus included ribavirin, interferon (alfa and beta), lopinavir-ritonavir combination, and corticosteroids. There remains controversy regarding their efficacy to date, except for the last one. Hence, large-scale multicentric trials are being conducted involving multiple drugs. Chloroquine and hydroxy-chloroquine were initially taking the race ahead but have now been rejected. Remdesivir was a promising candidate, for which the FDA had issued an emergency use authorization, but now is not recommended by the WHO. Convalescent plasma therapy had promising results in the early severe viremia phase, but the PLACID trial made an obscure end. Only corticosteroids have shown demonstrable benefits in improving mortality rates among severe COVID-19 cases. Many new modalities like monoclonal antibodies and tyrosine kinase inhibitors are discussed. In this chapter, we review the therapeutic drugs under investigation for the COVID-19 treatment, their mode of action, degree of effectiveness, and recommendations by different centers regarding their use in current settings.
Part of the book: Fighting the COVID-19 Pandemic
Disease pandemics are known to cause mental impact, COVID-19 is not an exception. The ensuing mental health issues are not only restricted to the patients and their relatives/friends but affect the healthcare workers (HCWs) as well. Home isolated/quarantined patients/care takers experience a greater tendency of fear, stress, anxiety, and depression compared to those admitted in the hospital. Similarly, HCWs posted in COVID-19 designated areas of the hospital display higher levels of mental problems in comparison to those posted in non-COVID areas. Furthermore, long COVID-19 syndrome encompasses another large mental impact after 4-12 weeks of acute illness. Several instruments are available to screen for anxiety, fear, stress and depression, including the PSS 10 and DASS 21 questionnaires. These can be used by any HCW and even by educated patients or their care takers with telemedicine guidance from HCW. Treatment is also simple and cognitive behavioral therapy is a major solution and can be markedly practice with tele-consultation. The high degree of uncertainty associated with novel pathogens like COVID-19, both during acute and chronic effects has a profound effect on the mental state of asymptomatic/suspected/confirmed patients, their care takers, friends, as well as HCWs. However, by accepting pandemic with new-normal life of COVID-19 appropriate behaviors, human mankind can overcome these impacts.
Part of the book: Psychosocial, Educational, and Economic Impacts of COVID-19