|
?:abstract
|
-
The mainstay of treatment consists of a three-pronged approach, including symptomatic and supportive management such as oxygen therapy, with or without mechanical ventilation, investigational antiviral therapies such as remdesivir, convalescent plasma (passive antibody transfer), etc , and investigational measures to counter the cytokine storm which is the presumed underlying mechanism of cardiopulmonary failure Some estimates suggest that 50% or more of all ventilated patients die, and unless extubation is rapidly achieved, this number approaches or even exceeds 80% Several antiviral drugs, including the adenosine analogue chain terminating agent remdesivir, are actively undergoing testing;however, to date none have been approved for COVID-19 Additionally, over two dozen vaccines, mesenchymal stem cell infusion therapy, as well as convalescent plasma therapy approaches are in development Hydroxychloroquine and azithromycin have been extensively promoted with little prospective data, in addition to a number of other empiric therapies Approaches that directly target the virus (such as microRNA-based therapies) or block viral entry (since the binding receptor is well known and can easily be targeted) are under active investigation However, it is not the viral infection that is the cause of death, but rather the cytokine storm unleashed by the immune system in response to the pathogen Thus, treatments that address the immunopathology of the cytokine storm are becoming a major focus in terms of improving the survival of patients who are rapidly hurtling toward a \'pneumonic\', respiratory-failure state Sadly, there is a cohort of individuals who are at higher risk for developing respiratory compromised COVID infections Currently, many of these individuals (i e , those aged >65, and those with pre-existing health conditions such as diabetes or heart disease, as well as immunocompromised patients) will end up on ventilator support Additionally, the mortality rates of those on prolonged ventilation are reported be as high as 88% It is believed that the underlying mechanism of this is uncontrolled inflammation induced by the cytokine storm
|
![[This page as RDF]](https://research.tib.eu/covid-19/static/rdf-icon.gif){kind=icon}