Treatment of severe COVID-19: an evolving paradigm

Link to article at PubMed

Expert Opin Pharmacother. 2022 Oct 21. doi: 10.1080/14656566.2022.2140041. Online ahead of print.

ABSTRACT

INTRODUCTION: The pathogenesis of severe COVID-19 is due, in part, to dysregulation of the human immune system in response to SARS-CoV-2 infection. Immune cells infected with SARS-CoV-2 can trigger a hyperinflammatory response of both the adaptive and innate immune system that has been associated with severe disease, hospitalization, and death, and better treatment options are urgently needed.

AREAS COVERED: A mainstay of therapy for COVID-19 involves an antiviral agent, remdesivir, in combination with a systemic corticosteroid, dexamethasone.

EXPERT OPINION: The addition of a second immunomodulator, such as an interleukin-6 inhibitor or a Janus kinase inhibitor, has been associated with clinical benefit in a subset of patients with moderate-to-severe disease, but their use remains controversial. This manuscript reviews what is known about the approach to treatment of severe COVID-19 and examines how immunomodulators such as infliximab and abatacept may alter clinical management and COVID-19 research in the years ahead based on the results of randomized, controlled trials.

PMID:36271630 | DOI:10.1080/14656566.2022.2140041

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