Drugs used symptomatically:
There is no proper medicines available for COVID-19 treatment but the medicines given to the patient is just to treat the symptoms or these are given symptomatically also no vaccine is still present to avoid its spread or to provide immunity to those who don’t have this infection Moore, J.B et al (2020). So, the symptomatic treatment which is given to the patients includes the drugs from different classes of drugs as; The drugs as from anti-malarial class and those also used in rheumatoid arthritis and systemic lupus erythmatosus (SLE) by decreasing the activity as of the immune system as 500mg of Chloroquine given after every 12 hours, along with200mg of hydroxychloroquine which is given after every 12 hours were anticipated as having immunomodulatory role in therapy Rosa, S.G et al (2020). Even though no any antiviral specific treatments have been accepted, numerous approaches have been anticipated like lopinavir/ritonavir as given 400/100 mg orally after every 12 hours Lu, Q et al (2020).
Nonetheless, a current randomized, restricted trial as open-label has verified that there is no advantage through treatment with lopinavir/ritonavir when compared with the ordinary care. Preclinical studies have recommended that the treatment with remdesivir (GS5734) acting as an inhibitor of the RNA polymerase by means of an in vitro action adjacent to the several RNA viruses Yang, H et al (2020), counting Ebola might be effectual in favor of both prophylaxis as well as therapy of HCoVs ( human coronaviruses) infections. It was used in MERS-COV infection and alpha-interferon were also used Mizumoto, K et al (2020). Noteworthy, in a trial that was non-randomized revealed that the use of hydroxychloroquine was considerably related with the reduction in the viral load in anticipation of viral desertion; furthermore, this result was improved by the use of the antibiotics as macrolides (e.g. azithromycin). Both In vitro as well as in vivo trials, certainly Shim, E et al (2020), have revealed that macrolides antibiotics may possibly alleviate inflammation as well as amend the immune system of the individual. Specifically, these drugs possibly will stimulate the decrease in the molecules as require for adhesion to the cell surface, plummeting the production of the proinflammatory cytokines, invigorating the process of phagocytosis through alveolar macrophages, as well as prohibiting the activation as well as recruitment of the neutrophils Kucharski, A.J et al (2020). Nevertheless, supplementary studies are required in favor of prescribing as well as recommending the exploit of azithromycin, unaccompanied or else coupled with supplementary drugs like hydroxychloroquine, exterior of any antibacterial groups Ludvigsson, J.F (2020). All over again, consideration ought to be remunerated by means of the associated use of the hydroxychloroquine along with azithromycin as alliance is able to escort to a elevated peril of the prolongation of the QT interval as well as arrhythmias. The use of Chloroquine can also encourage the prolongation of the QT interval Goyal, P et al (2020). For the reason that the patients of COVID-19 encompass an elevated prevalence of the venous thromboembolism along with anticoagulant therapy is linked through abridged ICU related death, it is recommended to the patients ought to be given the thromboprophylaxis therapy as well. Furthermore, in the case of identified thrombosis or thrombophilia, anticoagulation therapy as enoxaparin 1 mg/kg BD (twice daily) is recommended Jiang, F et al (2020). Another drug is use for the patients infected with COVID-19 and those who were in severe condition as Tocilizumab (monoclonal antibody and IL-6 blocker). A great number of the T lymphocytes as well as mononuclear type’s macrophages are stimulated, and produce the cytokines for instance IL-6 (interleukin-6), which attach to receptor of IL-6 on target cells, and cause storm of cytokine as well as stern inflammatory reactions in lungs as well as the supplementary tissues along with the organs Zhang, L et al (2020). Tocilizumab, is( recombinant humanized anti-human IL-6 receptor monoclonal antibody), can attach to the IL-6 receptor by means of elevated affinity, consequently, and it will prevent the IL-6 itself as from fastening to its own receptors, depiction as it is unable of the immune harm to the target cells, as well as reducing the inflammatory reactions Wu, J et al (2020). Another drug from the steroid group of drugs e.g. Dexamethasone which is a artificial corticosteroid accepted by the FDA( food and drug administration) as an immunosuppressor which is broad-spectrum in nature as well as it is almost 30 times as active as well as having the duration of action which is 2-3 days is also longer compared to cortisone Tang, B et al (2020). This drug would perimeter the assembly as well as detrimental consequences of the cytokines; although, it will also restrain the defensive role of T cells along with obstruct the B cells as of producing the antibodies, potentially it would leads to the amplified plasma load of virus that will endure subsequent to the survival of the patient from SARS Pan, L et al (2020). Furthermore, dexamethasone would also obstruct the macrophages from reimbursement secondary, hospital acquired infections. Consequently, dexamethasone may be helpful in favor of the use of the drug for shorter duration in rigorous and intubated patients of the COVID-19, however, it might be absolute treacherous throughout resurgence as the virus will not only endure, although, the body will be prohibited as of producing defensive antibodies Han, C et al (2020). As a substitute, a pulse of the intravenous (IV) dexamethasone possibly will be followed by giving the triamcinolone which is nebulized which is 6 times as vigorous as cortisone to contemplate in the lungs merely. The corticosteroids might be recommended mutually with the natural flavonoid ( luteolin) since it has antiviral as well as anti-inflammatory effects, particularly its aptitude to restrain mast cells, which are the major cause of the cytokines present in the lungs Soetikno, R et al (2020). A further study exposed that the drug as ivermectin has shown its effectiveness in COVID-19 patients and it is an anti-parasitic which have broad spectrum drug. Ivermectin is FDA standard drug, recognized to encompass the broad-spectrum antiviral action against many viruses in the in vitro circumstances Mehta, P et al (2020). Current investigation on the ivermectin in opposition to the SARS-CoV-2 in those as in vitro trials exposed that it can restrain the replication of the virus. The distinct treatment with this drug was proficient to lessen the virus replication as up to the 5000-fold in the culture in 48h. Conversely, there is no supplementary diminution was appeared as with auxiliary add to the time period as when increased up to 72h Hollander, J.E et al (2020). Furthermore, there is no toxicity of the drug with the use for either 48 or 72 hours. the Mechanism through which ivermectin showed response in opposition to the CoV-19 virus is not recognized as well as it was supposed to be functioning likewise as it show effect on other types of viruses. It was recognized to restrain the nuclear importation of the viral as well as the host proteins Zheng, Y et al (2020). The Integrase protein as of the viruses along with the IMP (importin) α/β1 heterodimer was accountable for those as nuclear import (IN) which additionally promotes the infection. Because the majority of the RNA types of viruses are reliant on the IMPα/β1 throughout the infection, Ivermectin show effect on it along with inhibition of the importation by means of the amplified antiviral effect Akalin, E et al (2020).