Comparative efficacy and safety of pharmacological interventions for severe COVID-19 patients: An updated network meta-analysis of 48 randomized controlled trials

Coronaviruses is a broad group of viruses that has the potential to cause mild or severe respiratory infections. Currently, there is no specific treatment for the treatment of COVID-19. The symptomatic treatment is generally given on case-to-case basis along with basic life supportive measures for management of COVID-19. There is an acute urgency of evaluating the pre-existing drugs to develop a convincing treatment for COVID-19 or at least to reduce its severity. 2-DG being inhibitor of both glycolysis and glycosylation appears as a promising therapeutic option. In the present chapter, the rationale of repurposing of 2-DG as a potential treatment option for the management of COVID-19 has been discussed. 

2-Deoxy-d-Glucose: A Repurposed Drug for COVID-19 Treatment

Hyperinflammation and cytokine storm has been noted as a poor prognostic factor in patients with severe pneumonia related to coronavirus disease 2019 (COVID-19). In COVID-19, pathogenic myeloid cell overactivation is found to be a vital mediator of damage to tissues, hypercoagulability, and the cytokine storm. These cytokines unselectively infiltrate various tissues, such as the lungs and heart, and nervous system. This cytokine storm can hence cause multi-organ dysfunction and life-threatening complications. Mavrilimumab is a monoclonal antibody (mAb) that may be helpful in some cases with COVID-19. During an inflammation, Granulocyte-macrophage colony-stimulating factor (GM-CSF) release is crucial to driving both innate and adaptive immune responses. The GM-CSF immune response is triggered when an antigen attaches to the host cell and induces the signaling pathway. Mavrilimumab antagonizes the action of GM-CSF and decreases the hyperinflammation associated with pneumonia in COVID-19, therefore strengthening the rationale that mavrilimumab when added to the standard protocol of treatment could improve the clinical outcomes in COVID-19 patients, specifically those patients with pneumonia. With this review paper, we aim to demonstrate the inhibitory effect of mavrilimumab on cytokine storms in patients with COVID-19 by reviewing published clinical trials and emphasize the importance of extensive future trials.

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Rupalakshmi Vijayan

Papers

Effectiveness of Mavrilimumab in viral infections including SARS-CoV-2 infection - A brief review