Antiviral treatment of COVID-19: a clinical pharmacology narrative review
Instiaty, I Gusti Agung Ayu Putu Sri Darmayani, Jefman Efendi Marzuki, Ferina Angelia, William, Angelina Siane, Lela Dwi Sary, Lina Yohanes, Reni Widyastuti, Riki Nova, Dewi Sharon Simorangkir, Lonah Lonah, Yolanda Safitri, Gestina Aliska, Anggi Gayatri
Abstract
The outbreak of coronavirus disease 2019 (COVID-19) in December 2019 in China, has become a pandemic in March 2020. Repurposing old and relatively safe drugs becomes an advantageous option to obtain the urgently needed effective treatment. Repurposing chloroquine, hydroxychloroquine, oseltamivir, lopinavir/ritonavir, andfavipiravir, and the use of investigational drug remdesivir for treatment of COVID-19, are reviewed from the clinical pharmacology perspective, particularly its efficacy and safety. Limited clinical studies of chloroquine, hydroxychloroquine, favipiravir, and remdesivir showed some efficacy in COVID-19 treatment with tolerable adverse effects. Potential serious adverse effect of chloroquine and hydroxychloroquine is cardiac arrhythmia. Oseltamivir has no documented activity against SARS-CoV-2, while lopinavir/ritonavir showed limited efficacy in COVID-19. Currently, there is no sufficient evidence to recommend any specific anti-COVID-19 treatment. The decision to use these drugs during the COVID-19 pandemic must be based on careful consideration of the potential benefits and risks to the patient.