PMC full text:
TABLE 7.
Antiviral agents and immunomodulators against SARS-CoV in vivo
| Antiviral agent and/or immunomodulator (no. of subjects) (study design) | Main findingsa | Reference |
|---|---|---|
| Ribavirin (144 patients) (retrospective case series) | 126 patients (88%) treated; side effects of hemolysis (76%) and lowered hemoglobin of 2 g/dl (49%) | 21 |
| Ribavirin (229 patients) (retrospective uncontrolled cohort analysis) | 97 patients (42.2%) treated; crude death rate of 10.3% (treatment) vs 12.9% (control) (P = 0.679) | 199 |
| Ribavirin and corticosteroids (75 patients) (prospective case series) | 9 patients (12%) had spontaneous pneumomediastinum; 20% developed ARDS in wk 3 | 258 |
| Ribavirin and MP (31 patientsb) (retrospective case series) | No patient required intubation or mechanical ventilation; no mortality noted in this series | 303 |
| Ribavirin and corticosteroidsc (71 patientsd) (prospective cohort study) | Crude mortality rate of 3.4% (only in patients aged >65 yr); none of the discharged survivors required continuation of oxygen therapy | 186 |
| Ribavirin and corticosteroidse (138 patients) (prospective uncontrolled study) | None responded to antibacterials; 25 patients (18.1%) responded to ribavirin and low-dose corticosteroid; 107 patients required high-dose MP, 88.8% of whom responded; 21 patients (15.2%) required mechanical ventilation; mortality rate, 10.9% | 314 |
| Ribavirin and MP (72 patientsf) (retrospective uncontrolled study) | Patients treated with initial pulse MP therapy had no better rate on mechanical ventilation (5.9% vs 9.1%) (NS) and mortality (5.9% vs 5.5%) (NS) | 139 |
| Lopinavir-ritonavir and ribavirin (41 patients) (retrospective study with historical control)g | ARDS and death were lower in treatment group than in historical control (2.4% vs 28.8%) (P < 0.001) at day 21 after symptom onset | 72 |
| Lopinavir-ritonavir as initial therapy (44 patients) (retrospective matched cohort study)h | Intubation rate of 0% vs 11% (P < 0.05); mortality rate of 2.3% vs 15.6% (P < 0.05) | 33 |
| Lopinavir-ritonavir as rescue therapy (31 patients) (retrospective matched cohort study)i | Intubation rate of 9.7% vs 18.1% (NS); mortality rate of 12.9% vs 14% (NS) | 33 |
| IFN-alfacon-1 and corticosteroids (22 patients) (open-label study) | 9 patients (40.9%) were treated; 1 (11.1%) patient required mechanical ventilation, and no patient died; of 13 patients (59.1%) treated with corticosteroid alone, 3 (23.1%) required mechanical ventilation and 1 (7.7%) died | 231 |
| Pentaglobin, an IgM-enriched immunoglobulin (12 patientsj) (retrospective analysis) | Improvement in radiographic scores compared with day 1 (median, 9.5) on days 6 (median, 6) (P = 0.01) and 7 (median, 6) (P = 0.01) and in oxygen requirement compared with day 1 (median, 2.5 liters/min) on days 6 (median, 1 liter/min) (P = 0.04) and 7 (median, 0.5 liters/min) (P = 0.04) after commencement of pentaglobin treatment | 140 |
| Convalescent plasma (1 patientk) (case report) | Convalescent plasma (200 ml) was given at day 15 after onset of illness without adverse reaction; patient recovered uneventfully | 366 |
| Convalescent plasma (3 patients) | Viral load decreased from 4.9 × 105-6.5 × 105 copies/ml to undetectable 1 day after transfusion | 401 |
| Convalescent plasma (80 patients) | A higher day 22 discharge rate was observed in patients treated before day 14 of illness (58.3% vs 15.6%) (P < 0.001), and in patients with positive PCR, SARS-CoV antibodies were negative at the time of plasma infusion (66.7% vs 20%) (P = 0.001) | 60 |
| Two herbal formulas (Sang Ju Yin and Yu Ping Feng San) (37 healthy volunteers) | Given oral traditional Chinese medicine regimen daily for 14 days with transient increase in CD4/CD8 ratio | 269 |
aARDS, acute respiratory distress syndrome; MP, methylprednisolone; NS, P value was not significant.
bOne patient recovered on antibacterial treatment alone.
cA 3-week step-down course of corticosteroids and pulsed methylprednisolone rescue for deterioration.
dThree patients recovered on antibacterial treatment alone.
eLow-dose corticosteroid and selective use of high-dose methylprednisolone.
fInitially treated with high-dose pulse (n = 17) versus nonpulse (n = 55) methylprednisolone.
gOne hundred eleven patients treated with ribavirin as a historical control.
hSix hundred thirty-four patients selected as matched cohort.
iThree hundred forty-three patients selected as matched cohort.
jPatients who continued to deteriorate despite ribavirin and corticosteroid therapy.
kPatient who continued to deteriorate despite ribavirin and corticosteroid therapy.