Elsevier

Respiratory Medicine

Volume 171, September 2020, 106114
Respiratory Medicine

Review article
Pharmacological management of COVID-19 patients with ARDS (CARDS): A narrative review

https://doi.org/10.1016/j.rmed.2020.106114Get rights and content
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Highlights

  • Supportive pharmacological treatments aimed on mitigating the morphological changes in CARDS are important.

  • No specific pharmacological treatments for CARDS exist right now.

  • There exist a number of drugs that may be useful at least in some patients.

  • The real challenge now is to link the right patient to the right available treatment.

Abstract

Coronavirus disease 2019 (COVID-19) is highly infectious. It has been highlighted that if not expertly and individually managed with consideration of the vasocentric features, a COVID-19 patient with an acute respiratory distress syndrome (CARDS) may eventually develop multiorgan failure. Unfortunately, there is still no definite drug for CARDS that is capable of reducing either short-term or long-term mortality and no specific treatments for COVID-19 exist right now. In this narrative review, based on a selective literature search in EMBASE, MEDLINE, Scopus, The Cochrane Library, Web of Science, and Google Scholar and ClinicalTrials.gov, we have examined the emerging evidence on the possible treatment of CARDS. Although numerous pharmacologic therapies to improve clinical outcomes in CARDS have been studied also in clinical trials, none have shown efficacy and there is great uncertainty about their effectiveness. There is still no recommendation for the therapeutic use of any specific agent to treat CARDS because no drugs are validated to have significant efficacy in clinical treatment of COVID-19 patients in large-scale trials. However, there exist a number of drugs that may be useful at least in some patients. The real challenge now is to link the right patient to the right treatment.

Keywords

ARDS
COVID-19
CARDS
Pharmacological therapy

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