A Systematic Review of antiviral therapeutic agents for the treatment of COVID-19

I. Introduction
The outbreak of novel coronavirus was initially reported to the World Health
Organization (WHO) on December 31, 20191. By March 17, 2020, 190,000 COVID-19
cases and approximately 7500 deaths from the virus were identified 2. This large number
of infected patients in only three months since the first reported case of COVID-19
demonstrates that the disease is extremely contagious2.
The etiologic agent of this pandemic is Severe Acute Respiratory Syndrome
Coronavirus 2 (SARS-CoV-2), causing disrupt of normal immune responses, leading to
cytokine storm with various local and systematic damage of tissues and organs 3. Local
damages primarily affect the lower respiratory tract and present as pneumonia with the
associated symptoms including fever, cough, expectoration, and hemoptysis. In addition
to pulmonary damages of COVID-19, the incidence of other symptoms are occurred,
includes heartbeat arrhythmia, hepatocellular injury, acute kidney injury, myocardial
dysfunction, neurological illnesses, and gastrointestinal symptoms4.
To date, no definitive cure has been discovered for COVID-19. However, some
case-reports or observational studies have reported several antiviral drugs being effective
in improving the outcome of COVID-19 patients 5. Many clinical trials are currently
underway to evaluate the efficacy of different medications on the outcome of COVID-19
patients, but their results have not been published yet. On the other hand, the quality of
these studies is rather unclear6. Thus, our goal is to review the role of several antiviral
agents includes, lopinavir ritonavir, ribavirin, remdesivir, arbidol, Ostalmovir, Favipiravir
in management of patients with COVID-19.
II. Methods

Database: PubMed, Google Scholar and sciencedirect

Key words: “COVID-19”, “SARS-COV-2”, “coronavirus 19” --> 6000an
Additional :::treatment”,“antiviral”, “lopinavir ritonavir”, “ribavirin”, ̈Remdesivir”,
“arbidol-->umifenovir????”, O
̈ stalmovir”, “Favipiravir”, -->
Study:: human studies, randomized controlled trials (RCT), prospective or retrospective
cohort designs, case-control designs, case series and case report

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Geneva: World Health Organization; 2020.
https://apps.who.int/iris/handle/10665/330760. Accessed 2021-07-05.
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City in China, Rapid Need for Emergency Departments Preparedness and Response; a
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carbonic anhydrase (CA) in pathogenesis of SARS-CoV-2. Biol. Proced. Online.
2020;22:11.
4. Li F., Lu H., Zhang Q., Li X., wang T., Liu Q., Yang Q., Qiang L. Impact of COVID-
19 on female fertility: a systematic review and meta-analysis protocol. BMJ Open.
2021;11(2).
5. Zhang J, Zhou L, Yang Y, Peng W, Wang W, Chen X. Therapeutic and triage
strategies for 2019 novel coronavirus disease in fever clinics. The Lancet Respiratory
Medicine. 2020
6. Zhu R-f, Gao R-l, Robert S-H, Gao J-p, Yang S-g, Zhu C. Systematic Review of the
Registered Clinical Trials of Coronavirus Diseases 2019 (COVID-19) medRxiv. 2020