Objectives

The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, also known as COVID-19 pandemic has caused an alarming situation worldwide. Since the first detection, in December 2019, there have been no effective drug therapy options for treating the SARS-CoV-2 pandemic. However, healthcare professionals are using chloroquine, hydroxychloroquine, remdesivir, convalescent plasma and some other options of treatments. This study aims to compare the biological, molecular, pharmacological, and clinical characteristics of these three treatment modalities for SARS-COV-2 infections, Chloroquine and Hydroxychloroquine, Convalescent Plasma, and Remdesivir.

Methods

A search was conducted in the “Institute of Science Information (ISI)-Web of Science, PubMed, EMBASE, ClinicalTrials.gov, Cochrane Library databases, Scopus, and Google Scholar” for peer reviewed, published studies and clinical trials through July 30, 2020. The search was based on keywords “COVID-19” SARS-COV-2, chloroquine, hydroxychloroquine, convalescent plasma, remdesivir and treatment modalities.

Results

As of July 30, 2020, a total of 36,640 relevant documents were published. From them 672 peer reviewed, published articles, and clinical trials were screened. We selected 17 relevant published original articles and clinical trials: 05 for chloroquine and/or hydroxychloroquine with total sample size (n = 220), 05 for Remdesivir (n = 1,781), and 07 for Convalescent Plasma therapy (n = 398), with a combined total sample size (n = 2,399). Based on the available data, convalescent plasma therapy showed clinical advantages in SARS-COV-2 patients.

Conclusions

All three treatment modalities have both favorable and unfavorable characteristics, but none showed clear evidence of benefit for early outpatient disease or prophylaxis. Based on the current available data, convalescent plasma therapy appears to show clinical advantages for inpatient use. In the future, ongoing large sample size randomized controlled clinical trials may further clarify the comparative efficacy and safety of these three treatment classes, to conclusively determine whom to treat with which drug and when to treat them.

中文翻译：

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氯喹、羟氯喹、恢复期血浆和瑞德西韦对 COVID-19 大流行的生物学、分子和药理学特征：比较分析。

目标

严重急性呼吸系统综合症冠状病毒 2 (SARS-CoV-2) 感染，也称为 COVID-19 大流行，已在全球范围内引起令人担忧的情况。自 2019 年 12 月首次检测以来，一直没有有效的药物治疗方案来治疗 SARS-CoV-2 大流行。然而，医疗保健专业人员正在使用氯喹、羟氯喹、瑞德西韦、恢复期血浆和其他一些治疗选择。本研究旨在比较 SARS-COV-2 感染、氯喹和羟氯喹、恢复期血浆和瑞德西韦这三种治疗方式的生物学、分子、药理学和临床特征。

方法

在“科学信息研究所 (ISI)-Web of Science、PubMed、EMBASE、ClinicalTrials.gov、Cochrane Library 数据库、Scopus 和 Google Scholar”中进行了搜索，以查找 7 月 30 日之前经过同行评审、发表的研究和临床试验， 2020 年。搜索基于关键词“COVID-19”、SARS-COV-2、氯喹、羟氯喹、恢复期血浆、瑞德西韦和治疗方式。

结果

截至2020年7月30日，共发布相关文件36640份。从中筛选出 672 篇经过同行评审、发表的文章和临床试验。我们选择了 17 篇相关的已发表原创文章和临床试验：05 篇针对氯喹和/或羟氯喹，总样本量 (n = 220)，05 篇针对 Remdesivir (n = 1,781)，07 篇针对恢复期血浆疗法 (n = 398)，其中总样本量 (n = 2,399)。根据现有数据，恢复期血浆疗法在 SARS-COV-2 患者中显示出临床优势。

结论

所有三种治疗方式都有有利和不利的特征，但没有一种显示出对早期门诊疾病或预防有益的明确证据。根据目前可用的数据，恢复期血浆疗法似乎显示出住院患者使用的临床优势。未来，正在进行的大样本随机对照临床试验可能会进一步阐明这三种治疗类别的疗效和安全性比较，最终确定用哪种药物治疗谁以及何时治疗。