Corticosteroidsreducelunginflammatoryresponses,whichmayleadtoARDS.However,theadverseeffectsmaysurpassthisbenefit,rangingfromdelayedviralclearancetoincreasedriskofsecondaryinfection.Astudydemonstratedthatpatientswhogetbenefitfromcorticosteroidsarethosewithbacterialratherthanviralinfections,hence,corticosteroidsmaybemorerecommendedincaseofadditionalbacterialinfectionoccurtoCOVID-19patient(Russelletal.,2020).
Immuneenhancementtherapy
Type1interferonshaveasignificantantiviralactivityinvitroandarecurrentlyeffectiveagainstSARS-CoVinclinicaltrials.Ithasbeendemonstratedthatinterferon1βmaybeasafeandeasyfortreatmentagainstCOVID-19intheearlystagesofinfection.SimilartherapieshadefficiencyagainstSARS-CoVviruses;however,invitrostudiesproposethatSARS-CoV-2couldbemarkedlymoresensitivetointerferon1thanothercoronaviruses(Sallardetal.,2020).Thecombinationofinterferon1withLopinavir/Ritonavir,Remdesivircouldenhanceitsefficacy,sincetheeffectivenessofsuchcombinationsobservedinvitroinothercoronaviruses(Sheahanetal.,2020).
Melatonin
Melatoninhasimmuneenhancing,anti-inflammationandanti-oxidantfeatures.Priorresearcheshavedocumentedthepotentialeffectsofmelatonininrelievingacuterespiratorydistressinducedbyvirus(Zhangetal.,2020d).Furthermore,MelatoninhasbeendemonstratedasapotentialadjuvanttherapyinCOVID-19patients(Zhangetal.,2020d). Inconclusion,thereisnostandardtherapyforallpatientsinfectedwithSARS-CoV-2.Further,clinicaltrialsarerequiredforallavailableoptionstomakesurefromeffectiveness,safetyandproperdosesrequiredtofightagainstthenewvirus.Withacloserlook,itwasfoundthatRemdesivirandFavipiravirarethemostpromisingagentsthatcanachievesuccessinthetreatmentofCovid19patients.Inourcurrentpandemicsituationallavailablechoicesshouldbetestedmaximallyeveniftheyusedforthemildcasesonly.WorldshouldbereadyforanypossiblesecondwaveofSARS-CoV-2