PHARMACOLOGICAL TREATMENT OF COVID-19 IN THE LIGHT OF EVIDENCE: THE MAIN DRUGS, THEIR INDICATIONS AND THEIR THERAPEUTIC MANAGEMENT, AN INTEGRATIVE REVIEW

Abstract

Introduction: The COVID 19 Pandemic brought, in a short period of time, a large number of infected patients with about 20% of them evolving to the severe or critical form of the disease, requiring hospitalization (WHO, 2021). The great search for health services and the high number of deaths brought haste to science for the discovery of possible medications and therapeutic actions that would mitigate the harmful consequences of the pandemic. Objectives: Thus, the present study lends itself to discussing, in the light of the best evidence and recommendations, the main drugs analyzed in the treatment of the disease (dexamethasone, tocilizumab, remdesivir, immunoglobulin, ivermectin and hydroxychloroquine, among others), their indications (or contraindications) ) and forms of use. Methods: A comprehensive review of the literature will be carried out on databases, medical information and scientific articles, known to the scientific community, such as Uptodate®, Dynamed®, Scielo®, PubMed®, Google Scholar®, among others, in order to After compiling the best evidence and indications for each pharmacological treatment, the descriptors used in the research were “drug in question” AND “treatment of COVID-19”. Results: Among the current recommendations: benefits have been demonstrated that outweigh possible risks for the use of Dexamethasone in patients who need oxygen support; toxilizumab is recommended for use with benefits in patients who progress to a severe or critical condition, or to those who persist with high inflammatory markers despite dexamethasone therapy; redemsivir also demonstrated its greatest clinical benefit in hospitalized patients, under low flow oxygen therapy; the bamlavizumab / etesevisumab association demonstrated a possible benefit for patients with the mild form of the disease who present risk conditions for an unfavorable clinical outcome. Among other drugs, there is no specific indication for their use, or they need more quality clinical trials. Conclusions: Formal recommendations were found for the use of some drugs for the treatment of COVID-19, such as Dexamethasone, Tocilizumab, Redemsivir and bamlavizumab / etesevisumab, while others lack more robust studies for use outside the context of clinical trials.