Ontology type: schema:ScholarlyArticle Open Access: True
2020-10-17
AUTHORSFabrizio Cantini, Delia Goletti, Linda Petrone, Saied Najafi Fard, Laura Niccoli, Rosario Foti
ABSTRACTBackgroundBased on current evidence, recent guidelines of the National Institute of Health, USA indicated the use of remdesivir and dexamethasone for the treatment of COVID-19 patients with mild-moderate disease, not requiring high-flow oxygen. No therapeutic agent directed against the immunologic pathogenic mechanisms related to the cytokine release syndrome complicating the disease was indicated.ObjectivesThe purpose of this review was to assess the clinical impact of different therapies for COVID-19; thus, helping to identify the optimal management of the disease. To explain the rationale for the different therapeutic approaches, the characteristics of SARS-CoV-2, the pathogenesis of COVID-19, and the immune response triggered by SARS-CoV-2 infection were reported.MethodsThe efficacy assessment of the different treatments was performed by a systematic review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Available English language published articles including randomised controlled trials, open-label trials of antivirals and immune therapies extracted from Medline, Google Scholar, and MedRxiv databases were analysed. For inclusion, the primary end point of the trials had to be the efficacy as measured by the improvement of clinical features, or mortality, or the Intensive Care Unit Admission rate, or the discharge number. Case reports, paediatric studies, and studies without control group were excluded. The literature search was extended up to August 15, 2020.ResultsAfter the removal of duplicate articles, and the exclusion of studies not meeting the eligibility criteria, 2 trials of lopinavir/ritonavir, 1 of favipiravir, 3 of remdesivir, 1 of dexamethasone, 3 of hydroxychloroquine, 2 of colchicine, 6 of tocilizumab, 1 of sarilumab, 1 of siltuximab, 2 of anakinra, 3 of baricitinib, 1 of ruxolitinib, 1 of mavrilimumab, and 1 of itolizumab were suitable for the review. Among antivirals, only remdesivir significantly reduced the time to recovery, and mortality. Data for chloroquine and hydroxychloroquine were largely inconclusive. In a large trial, dexamethasone 6 mg/day reduced mortality by one-third. Trials of tocilizumab and sarilumab did not definitively demonstrate efficacy. Anakinra significantly reduced the mortality in 2 trials. Three retrospective trials on a cumulative number of 145 patients, reported the efficacy of baricitinib, with significant reduction of intensive care unit admission, and deaths. These results were recently confirmed by the ACTT-2 trial. Due to paucity of studies and to the small size clinical series, the results of other immune therapies were not conclusive.ConclusionsBeyond the supportive therapy, up to now the best therapeutic approach for COVID-19 may be a three-step combination therapy, including remdesivir 100 mg/day (200 mg loading dose on first day) in the first stage of the disease, and combined dexamethasone 6 mg/day plus baricitinib 4 mg/day to target the immune dysregulation triggered by the SARS-CoV-2 infection. The promising results of anakinra should be confirmed by the ongoing RCTs. More... »
PAGES1929-1946
http://scigraph.springernature.com/pub.10.1007/s40265-020-01421-w
DOIhttp://dx.doi.org/10.1007/s40265-020-01421-w
DIMENSIONShttps://app.dimensions.ai/details/publication/pub.1131847400
PUBMEDhttps://www.ncbi.nlm.nih.gov/pubmed/33068263
JSON-LD is the canonical representation for SciGraph data.
TIP: You can open this SciGraph record using an external JSON-LD service: JSON-LD Playground Google SDTT
[
{
"@context": "https://springernature.github.io/scigraph/jsonld/sgcontext.json",
"about": [
{
"id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/11",
"inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/",
"name": "Medical and Health Sciences",
"type": "DefinedTerm"
},
{
"id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/1103",
"inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/",
"name": "Clinical Sciences",
"type": "DefinedTerm"
},
{
"inDefinedTermSet": "https://www.nlm.nih.gov/mesh/",
"name": "Adenosine Monophosphate",
"type": "DefinedTerm"
},
{
"inDefinedTermSet": "https://www.nlm.nih.gov/mesh/",
"name": "Alanine",
"type": "DefinedTerm"
},
{
"inDefinedTermSet": "https://www.nlm.nih.gov/mesh/",
"name": "Anti-Inflammatory Agents",
"type": "DefinedTerm"
},
{
"inDefinedTermSet": "https://www.nlm.nih.gov/mesh/",
"name": "Antibodies, Monoclonal, Humanized",
"type": "DefinedTerm"
},
{
"inDefinedTermSet": "https://www.nlm.nih.gov/mesh/",
"name": "Antiviral Agents",
"type": "DefinedTerm"
},
{
"inDefinedTermSet": "https://www.nlm.nih.gov/mesh/",
"name": "Biological Products",
"type": "DefinedTerm"
},
{
"inDefinedTermSet": "https://www.nlm.nih.gov/mesh/",
"name": "COVID-19",
"type": "DefinedTerm"
},
{
"inDefinedTermSet": "https://www.nlm.nih.gov/mesh/",
"name": "Cytokines",
"type": "DefinedTerm"
},
{
"inDefinedTermSet": "https://www.nlm.nih.gov/mesh/",
"name": "Dexamethasone",
"type": "DefinedTerm"
},
{
"inDefinedTermSet": "https://www.nlm.nih.gov/mesh/",
"name": "Drug Therapy, Combination",
"type": "DefinedTerm"
},
{
"inDefinedTermSet": "https://www.nlm.nih.gov/mesh/",
"name": "Humans",
"type": "DefinedTerm"
},
{
"inDefinedTermSet": "https://www.nlm.nih.gov/mesh/",
"name": "Inflammation Mediators",
"type": "DefinedTerm"
},
{
"inDefinedTermSet": "https://www.nlm.nih.gov/mesh/",
"name": "Intensive Care Units",
"type": "DefinedTerm"
},
{
"inDefinedTermSet": "https://www.nlm.nih.gov/mesh/",
"name": "Pandemics",
"type": "DefinedTerm"
},
{
"inDefinedTermSet": "https://www.nlm.nih.gov/mesh/",
"name": "Retrospective Studies",
"type": "DefinedTerm"
},
{
"inDefinedTermSet": "https://www.nlm.nih.gov/mesh/",
"name": "SARS-CoV-2",
"type": "DefinedTerm"
}
],
"author": [
{
"affiliation": {
"alternateName": "Department of Rheumatology, Azienda USL Toscana Centro, Hospital of Prato, Prato, Italy",
"id": "http://www.grid.ac/institutes/grid.430148.a",
"name": [
"Department of Rheumatology, Azienda USL Toscana Centro, Hospital of Prato, Prato, Italy"
],
"type": "Organization"
},
"familyName": "Cantini",
"givenName": "Fabrizio",
"id": "sg:person.01212617510.19",
"sameAs": [
"https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01212617510.19"
],
"type": "Person"
},
{
"affiliation": {
"alternateName": "Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy",
"id": "http://www.grid.ac/institutes/grid.419423.9",
"name": [
"Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy"
],
"type": "Organization"
},
"familyName": "Goletti",
"givenName": "Delia",
"id": "sg:person.01200446072.99",
"sameAs": [
"https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01200446072.99"
],
"type": "Person"
},
{
"affiliation": {
"alternateName": "Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy",
"id": "http://www.grid.ac/institutes/grid.419423.9",
"name": [
"Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy"
],
"type": "Organization"
},
"familyName": "Petrone",
"givenName": "Linda",
"id": "sg:person.0755160366.91",
"sameAs": [
"https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0755160366.91"
],
"type": "Person"
},
{
"affiliation": {
"alternateName": "Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy",
"id": "http://www.grid.ac/institutes/grid.419423.9",
"name": [
"Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy"
],
"type": "Organization"
},
"familyName": "Najafi Fard",
"givenName": "Saied",
"id": "sg:person.01326370162.46",
"sameAs": [
"https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01326370162.46"
],
"type": "Person"
},
{
"affiliation": {
"alternateName": "Department of Rheumatology, Azienda USL Toscana Centro, Hospital of Prato, Prato, Italy",
"id": "http://www.grid.ac/institutes/grid.430148.a",
"name": [
"Department of Rheumatology, Azienda USL Toscana Centro, Hospital of Prato, Prato, Italy"
],
"type": "Organization"
},
"familyName": "Niccoli",
"givenName": "Laura",
"id": "sg:person.01145652405.31",
"sameAs": [
"https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01145652405.31"
],
"type": "Person"
},
{
"affiliation": {
"alternateName": "Rheumatology Unit, Vittorio-Emanuele University Hospital of Catania, Catania, Italy",
"id": "http://www.grid.ac/institutes/grid.412844.f",
"name": [
"Rheumatology Unit, Vittorio-Emanuele University Hospital of Catania, Catania, Italy"
],
"type": "Organization"
},
"familyName": "Foti",
"givenName": "Rosario",
"id": "sg:person.01135302217.49",
"sameAs": [
"https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01135302217.49"
],
"type": "Person"
}
],
"citation": [
{
"id": "sg:pub.10.1038/s41467-020-17240-2",
"sameAs": [
"https://app.dimensions.ai/details/publication/pub.1129065459",
"https://doi.org/10.1038/s41467-020-17240-2"
],
"type": "CreativeWork"
},
{
"id": "sg:pub.10.1038/s41586-020-2012-7",
"sameAs": [
"https://app.dimensions.ai/details/publication/pub.1124545162",
"https://doi.org/10.1038/s41586-020-2012-7"
],
"type": "CreativeWork"
},
{
"id": "sg:pub.10.1038/s41392-020-0191-1",
"sameAs": [
"https://app.dimensions.ai/details/publication/pub.1127986286",
"https://doi.org/10.1038/s41392-020-0191-1"
],
"type": "CreativeWork"
},
{
"id": "sg:pub.10.1038/s41591-020-0817-4",
"sameAs": [
"https://app.dimensions.ai/details/publication/pub.1125618973",
"https://doi.org/10.1038/s41591-020-0817-4"
],
"type": "CreativeWork"
},
{
"id": "sg:pub.10.1038/s41591-020-0869-5",
"sameAs": [
"https://app.dimensions.ai/details/publication/pub.1126655280",
"https://doi.org/10.1038/s41591-020-0869-5"
],
"type": "CreativeWork"
},
{
"id": "sg:pub.10.1038/s41375-020-0848-3",
"sameAs": [
"https://app.dimensions.ai/details/publication/pub.1127377041",
"https://doi.org/10.1038/s41375-020-0848-3"
],
"type": "CreativeWork"
},
{
"id": "sg:pub.10.1007/s12250-020-00207-4",
"sameAs": [
"https://app.dimensions.ai/details/publication/pub.1125334309",
"https://doi.org/10.1007/s12250-020-00207-4"
],
"type": "CreativeWork"
},
{
"id": "sg:pub.10.1038/s41577-020-0328-z",
"sameAs": [
"https://app.dimensions.ai/details/publication/pub.1127257736",
"https://doi.org/10.1038/s41577-020-0328-z"
],
"type": "CreativeWork"
},
{
"id": "sg:pub.10.1007/s00296-020-04603-7",
"sameAs": [
"https://app.dimensions.ai/details/publication/pub.1127647339",
"https://doi.org/10.1007/s00296-020-04603-7"
],
"type": "CreativeWork"
}
],
"datePublished": "2020-10-17",
"datePublishedReg": "2020-10-17",
"description": "BackgroundBased on current evidence, recent guidelines of the National Institute of Health, USA indicated the use of remdesivir and dexamethasone for the treatment of COVID-19 patients with mild-moderate disease, not requiring high-flow oxygen. No therapeutic agent directed against the immunologic pathogenic mechanisms related to the cytokine release syndrome complicating the disease was indicated.ObjectivesThe purpose of this review was to assess the clinical impact of different therapies for COVID-19; thus, helping to identify the optimal management of the disease. To explain the rationale for the different therapeutic approaches, the characteristics of SARS-CoV-2, the pathogenesis of COVID-19, and the immune response triggered by SARS-CoV-2 infection were reported.MethodsThe efficacy assessment of the different treatments was performed by a systematic review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Available English language published articles including randomised controlled trials, open-label trials of antivirals and immune therapies extracted from Medline, Google Scholar, and MedRxiv databases were analysed. For inclusion, the primary end point of the trials had to be the efficacy as measured by the improvement of clinical features, or mortality, or the Intensive Care Unit Admission rate, or the discharge number. Case reports, paediatric studies, and studies without control group were excluded. The literature search was extended up to August 15, 2020.ResultsAfter the removal of duplicate articles, and the exclusion of studies not meeting the eligibility criteria, 2 trials of lopinavir/ritonavir, 1 of favipiravir, 3 of remdesivir, 1 of dexamethasone, 3 of hydroxychloroquine, 2 of colchicine, 6 of tocilizumab, 1 of sarilumab, 1 of siltuximab, 2 of anakinra, 3 of baricitinib, 1 of ruxolitinib, 1 of mavrilimumab, and 1 of itolizumab were suitable for the review. Among antivirals, only remdesivir significantly reduced the time to recovery, and mortality. Data for chloroquine and hydroxychloroquine were largely inconclusive. In a large trial, dexamethasone 6\u00a0mg/day reduced mortality by one-third. Trials of tocilizumab and sarilumab did not definitively demonstrate efficacy. Anakinra significantly reduced the mortality in 2 trials. Three retrospective trials on a cumulative number of 145 patients, reported the efficacy of baricitinib, with significant reduction of intensive care unit admission, and deaths. These results were recently confirmed by the ACTT-2 trial. Due to paucity of studies and to the small size clinical series, the results of other immune therapies were not conclusive.ConclusionsBeyond the supportive therapy, up to now the best therapeutic approach for COVID-19 may be a three-step combination therapy, including remdesivir 100\u00a0mg/day (200\u00a0mg loading dose on first day) in the first stage of the disease, and combined dexamethasone 6\u00a0mg/day plus baricitinib 4\u00a0mg/day to target the immune dysregulation triggered by the SARS-CoV-2 infection. The promising results of anakinra should be confirmed by the ongoing RCTs.",
"genre": "article",
"id": "sg:pub.10.1007/s40265-020-01421-w",
"inLanguage": "en",
"isAccessibleForFree": true,
"isPartOf": [
{
"id": "sg:journal.1084788",
"issn": [
"0012-6667",
"1179-1950"
],
"name": "Drugs",
"publisher": "Springer Nature",
"type": "Periodical"
},
{
"issueNumber": "18",
"type": "PublicationIssue"
},
{
"type": "PublicationVolume",
"volumeNumber": "80"
}
],
"keywords": [
"SARS-CoV-2 infection",
"immune therapy",
"systematic review",
"therapeutic approaches",
"intensive care unit admission rate",
"COVID-19",
"intensive care unit admission",
"mild-moderate disease",
"trial of tocilizumab",
"efficacy of baricitinib",
"cytokine release syndrome",
"open-label trial",
"primary end point",
"care unit admission",
"use of remdesivir",
"high-flow oxygen",
"lopinavir/ritonavir",
"COVID-19 patients",
"best therapeutic approach",
"different therapeutic approaches",
"Preferred Reporting Items",
"SARS-CoV-2",
"exclusion of studies",
"release syndrome",
"unit admission",
"dexamethasone 6",
"baricitinib 4",
"medRxiv databases",
"immune dysregulation",
"clinical features",
"supportive therapy",
"ongoing RCTs",
"antiviral therapy",
"large trials",
"retrospective trials",
"pediatric studies",
"clinical series",
"combination therapy",
"recent guidelines",
"admission rates",
"clinical impact",
"different therapies",
"immune response",
"paucity of studies",
"current evidence",
"efficacy assessment",
"eligibility criteria",
"pathogenic mechanisms",
"Reporting Items",
"available English-language",
"control group",
"therapy",
"Meta-Analysis",
"optimal management",
"anakinra",
"end point",
"literature search",
"therapeutic agents",
"ObjectivesThe purpose",
"mortality",
"remdesivir",
"disease",
"trials",
"Google Scholar",
"National Institute",
"tocilizumab",
"sarilumab",
"hydroxychloroquine",
"patients",
"efficacy",
"baricitinib",
"significant reduction",
"duplicate articles",
"antivirals",
"one-third",
"infection",
"days",
"cumulative number",
"treatment",
"review",
"mavrilimumab",
"itolizumab",
"siltuximab",
"different treatments",
"RCTs",
"ritonavir",
"admission",
"MEDLINE",
"ruxolitinib",
"syndrome",
"pathogenesis",
"dexamethasone",
"favipiravir",
"chloroquine",
"study",
"dysregulation",
"death",
"English language",
"promising results",
"health",
"colchicine",
"paucity",
"guidelines",
"group",
"agents",
"response",
"rationale",
"assessment",
"evidence",
"management",
"database",
"criteria",
"cases",
"recovery",
"Institute",
"number",
"results",
"rate",
"reduction",
"exclusion",
"improvement",
"mechanism",
"search",
"use",
"stage",
"items",
"purpose",
"inclusion",
"data",
"ConclusionsBeyond",
"removal",
"impact",
"time",
"article",
"features",
"series",
"characteristics",
"USA",
"approach",
"accordance",
"discharge number",
"first stage",
"point",
"oxygen",
"scholars",
"language"
],
"name": "Immune Therapy, or Antiviral Therapy, or Both for COVID-19: A Systematic Review",
"pagination": "1929-1946",
"productId": [
{
"name": "dimensions_id",
"type": "PropertyValue",
"value": [
"pub.1131847400"
]
},
{
"name": "doi",
"type": "PropertyValue",
"value": [
"10.1007/s40265-020-01421-w"
]
},
{
"name": "pubmed_id",
"type": "PropertyValue",
"value": [
"33068263"
]
}
],
"sameAs": [
"https://doi.org/10.1007/s40265-020-01421-w",
"https://app.dimensions.ai/details/publication/pub.1131847400"
],
"sdDataset": "articles",
"sdDatePublished": "2022-05-10T10:27",
"sdLicense": "https://scigraph.springernature.com/explorer/license/",
"sdPublisher": {
"name": "Springer Nature - SN SciGraph project",
"type": "Organization"
},
"sdSource": "s3://com-springernature-scigraph/baseset/20220509/entities/gbq_results/article/article_859.jsonl",
"type": "ScholarlyArticle",
"url": "https://doi.org/10.1007/s40265-020-01421-w"
}
]
Download the RDF metadata as: json-ld nt turtle xml License info
JSON-LD is a popular format for linked data which is fully compatible with JSON.
curl -H 'Accept: application/ld+json' 'https://scigraph.springernature.com/pub.10.1007/s40265-020-01421-w'
N-Triples is a line-based linked data format ideal for batch operations.
curl -H 'Accept: application/n-triples' 'https://scigraph.springernature.com/pub.10.1007/s40265-020-01421-w'
Turtle is a human-readable linked data format.
curl -H 'Accept: text/turtle' 'https://scigraph.springernature.com/pub.10.1007/s40265-020-01421-w'
RDF/XML is a standard XML format for linked data.
curl -H 'Accept: application/rdf+xml' 'https://scigraph.springernature.com/pub.10.1007/s40265-020-01421-w'
This table displays all metadata directly associated to this object as RDF triples.
349 TRIPLES
22 PREDICATES
196 URIs
179 LITERALS
23 BLANK NODES
Subject | Predicate | Object | |
---|---|---|---|
1 | sg:pub.10.1007/s40265-020-01421-w | schema:about | N2bfd0e5f9dc84492be672a466a81b4df |
2 | ″ | ″ | N56797668da0648e384751a930b41f6a3 |
3 | ″ | ″ | N5ab3f8611e26424dac51fe5f4ce7c10e |
4 | ″ | ″ | N619239a0c67c4d579c26a1de40c33168 |
5 | ″ | ″ | N64c133cd80b9458780182615fd85b010 |
6 | ″ | ″ | N78288e1be1414888806af8837a23ff54 |
7 | ″ | ″ | N8bf3bfcec3464acab821899657b128c1 |
8 | ″ | ″ | N8e20384481cb40b9946efcb6d022657a |
9 | ″ | ″ | N90d1ec1aa94f45dba5d58dfe9a7569d1 |
10 | ″ | ″ | N9a81e6c389e44dbd8ed34b9355ffa83f |
11 | ″ | ″ | N9bdeca9df17945ef8de12e186409f978 |
12 | ″ | ″ | Nad41b01c4eab4c379926dbbe3869a3f6 |
13 | ″ | ″ | Nc535e9288c8f42f487596bbeb95b1aee |
14 | ″ | ″ | Nd239640e87444894942bf859c5274751 |
15 | ″ | ″ | Nf338409e95b64351bfb0bf3f139f5f1e |
16 | ″ | ″ | Nfc290dbfc95f4983aad6bc0b09d16176 |
17 | ″ | ″ | anzsrc-for:11 |
18 | ″ | ″ | anzsrc-for:1103 |
19 | ″ | schema:author | N44bb2fe2a2814aafbfd77a3cb4992ab4 |
20 | ″ | schema:citation | sg:pub.10.1007/s00296-020-04603-7 |
21 | ″ | ″ | sg:pub.10.1007/s12250-020-00207-4 |
22 | ″ | ″ | sg:pub.10.1038/s41375-020-0848-3 |
23 | ″ | ″ | sg:pub.10.1038/s41392-020-0191-1 |
24 | ″ | ″ | sg:pub.10.1038/s41467-020-17240-2 |
25 | ″ | ″ | sg:pub.10.1038/s41577-020-0328-z |
26 | ″ | ″ | sg:pub.10.1038/s41586-020-2012-7 |
27 | ″ | ″ | sg:pub.10.1038/s41591-020-0817-4 |
28 | ″ | ″ | sg:pub.10.1038/s41591-020-0869-5 |
29 | ″ | schema:datePublished | 2020-10-17 |
30 | ″ | schema:datePublishedReg | 2020-10-17 |
31 | ″ | schema:description | BackgroundBased on current evidence, recent guidelines of the National Institute of Health, USA indicated the use of remdesivir and dexamethasone for the treatment of COVID-19 patients with mild-moderate disease, not requiring high-flow oxygen. No therapeutic agent directed against the immunologic pathogenic mechanisms related to the cytokine release syndrome complicating the disease was indicated.ObjectivesThe purpose of this review was to assess the clinical impact of different therapies for COVID-19; thus, helping to identify the optimal management of the disease. To explain the rationale for the different therapeutic approaches, the characteristics of SARS-CoV-2, the pathogenesis of COVID-19, and the immune response triggered by SARS-CoV-2 infection were reported.MethodsThe efficacy assessment of the different treatments was performed by a systematic review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Available English language published articles including randomised controlled trials, open-label trials of antivirals and immune therapies extracted from Medline, Google Scholar, and MedRxiv databases were analysed. For inclusion, the primary end point of the trials had to be the efficacy as measured by the improvement of clinical features, or mortality, or the Intensive Care Unit Admission rate, or the discharge number. Case reports, paediatric studies, and studies without control group were excluded. The literature search was extended up to August 15, 2020.ResultsAfter the removal of duplicate articles, and the exclusion of studies not meeting the eligibility criteria, 2 trials of lopinavir/ritonavir, 1 of favipiravir, 3 of remdesivir, 1 of dexamethasone, 3 of hydroxychloroquine, 2 of colchicine, 6 of tocilizumab, 1 of sarilumab, 1 of siltuximab, 2 of anakinra, 3 of baricitinib, 1 of ruxolitinib, 1 of mavrilimumab, and 1 of itolizumab were suitable for the review. Among antivirals, only remdesivir significantly reduced the time to recovery, and mortality. Data for chloroquine and hydroxychloroquine were largely inconclusive. In a large trial, dexamethasone 6 mg/day reduced mortality by one-third. Trials of tocilizumab and sarilumab did not definitively demonstrate efficacy. Anakinra significantly reduced the mortality in 2 trials. Three retrospective trials on a cumulative number of 145 patients, reported the efficacy of baricitinib, with significant reduction of intensive care unit admission, and deaths. These results were recently confirmed by the ACTT-2 trial. Due to paucity of studies and to the small size clinical series, the results of other immune therapies were not conclusive.ConclusionsBeyond the supportive therapy, up to now the best therapeutic approach for COVID-19 may be a three-step combination therapy, including remdesivir 100 mg/day (200 mg loading dose on first day) in the first stage of the disease, and combined dexamethasone 6 mg/day plus baricitinib 4 mg/day to target the immune dysregulation triggered by the SARS-CoV-2 infection. The promising results of anakinra should be confirmed by the ongoing RCTs. |
32 | ″ | schema:genre | article |
33 | ″ | schema:inLanguage | en |
34 | ″ | schema:isAccessibleForFree | true |
35 | ″ | schema:isPartOf | N0de2275bf2704e43bc28a751468e44d9 |
36 | ″ | ″ | N80eebbf0cfe74e399e77934870b16f8b |
37 | ″ | ″ | sg:journal.1084788 |
38 | ″ | schema:keywords | COVID-19 |
39 | ″ | ″ | COVID-19 patients |
40 | ″ | ″ | ConclusionsBeyond |
41 | ″ | ″ | English language |
42 | ″ | ″ | Google Scholar |
43 | ″ | ″ | Institute |
44 | ″ | ″ | MEDLINE |
45 | ″ | ″ | Meta-Analysis |
46 | ″ | ″ | National Institute |
47 | ″ | ″ | ObjectivesThe purpose |
48 | ″ | ″ | Preferred Reporting Items |
49 | ″ | ″ | RCTs |
50 | ″ | ″ | Reporting Items |
51 | ″ | ″ | SARS-CoV-2 |
52 | ″ | ″ | SARS-CoV-2 infection |
53 | ″ | ″ | USA |
54 | ″ | ″ | accordance |
55 | ″ | ″ | admission |
56 | ″ | ″ | admission rates |
57 | ″ | ″ | agents |
58 | ″ | ″ | anakinra |
59 | ″ | ″ | antiviral therapy |
60 | ″ | ″ | antivirals |
61 | ″ | ″ | approach |
62 | ″ | ″ | article |
63 | ″ | ″ | assessment |
64 | ″ | ″ | available English-language |
65 | ″ | ″ | baricitinib |
66 | ″ | ″ | baricitinib 4 |
67 | ″ | ″ | best therapeutic approach |
68 | ″ | ″ | care unit admission |
69 | ″ | ″ | cases |
70 | ″ | ″ | characteristics |
71 | ″ | ″ | chloroquine |
72 | ″ | ″ | clinical features |
73 | ″ | ″ | clinical impact |
74 | ″ | ″ | clinical series |
75 | ″ | ″ | colchicine |
76 | ″ | ″ | combination therapy |
77 | ″ | ″ | control group |
78 | ″ | ″ | criteria |
79 | ″ | ″ | cumulative number |
80 | ″ | ″ | current evidence |
81 | ″ | ″ | cytokine release syndrome |
82 | ″ | ″ | data |
83 | ″ | ″ | database |
84 | ″ | ″ | days |
85 | ″ | ″ | death |
86 | ″ | ″ | dexamethasone |
87 | ″ | ″ | dexamethasone 6 |
88 | ″ | ″ | different therapeutic approaches |
89 | ″ | ″ | different therapies |
90 | ″ | ″ | different treatments |
91 | ″ | ″ | discharge number |
92 | ″ | ″ | disease |
93 | ″ | ″ | duplicate articles |
94 | ″ | ″ | dysregulation |
95 | ″ | ″ | efficacy |
96 | ″ | ″ | efficacy assessment |
97 | ″ | ″ | efficacy of baricitinib |
98 | ″ | ″ | eligibility criteria |
99 | ″ | ″ | end point |
100 | ″ | ″ | evidence |
101 | ″ | ″ | exclusion |
102 | ″ | ″ | exclusion of studies |
103 | ″ | ″ | favipiravir |
104 | ″ | ″ | features |
105 | ″ | ″ | first stage |
106 | ″ | ″ | group |
107 | ″ | ″ | guidelines |
108 | ″ | ″ | health |
109 | ″ | ″ | high-flow oxygen |
110 | ″ | ″ | hydroxychloroquine |
111 | ″ | ″ | immune dysregulation |
112 | ″ | ″ | immune response |
113 | ″ | ″ | immune therapy |
114 | ″ | ″ | impact |
115 | ″ | ″ | improvement |
116 | ″ | ″ | inclusion |
117 | ″ | ″ | infection |
118 | ″ | ″ | intensive care unit admission |
119 | ″ | ″ | intensive care unit admission rate |
120 | ″ | ″ | items |
121 | ″ | ″ | itolizumab |
122 | ″ | ″ | language |
123 | ″ | ″ | large trials |
124 | ″ | ″ | literature search |
125 | ″ | ″ | lopinavir/ritonavir |
126 | ″ | ″ | management |
127 | ″ | ″ | mavrilimumab |
128 | ″ | ″ | mechanism |
129 | ″ | ″ | medRxiv databases |
130 | ″ | ″ | mild-moderate disease |
131 | ″ | ″ | mortality |
132 | ″ | ″ | number |
133 | ″ | ″ | one-third |
134 | ″ | ″ | ongoing RCTs |
135 | ″ | ″ | open-label trial |
136 | ″ | ″ | optimal management |
137 | ″ | ″ | oxygen |
138 | ″ | ″ | pathogenesis |
139 | ″ | ″ | pathogenic mechanisms |
140 | ″ | ″ | patients |
141 | ″ | ″ | paucity |
142 | ″ | ″ | paucity of studies |
143 | ″ | ″ | pediatric studies |
144 | ″ | ″ | point |
145 | ″ | ″ | primary end point |
146 | ″ | ″ | promising results |
147 | ″ | ″ | purpose |
148 | ″ | ″ | rate |
149 | ″ | ″ | rationale |
150 | ″ | ″ | recent guidelines |
151 | ″ | ″ | recovery |
152 | ″ | ″ | reduction |
153 | ″ | ″ | release syndrome |
154 | ″ | ″ | remdesivir |
155 | ″ | ″ | removal |
156 | ″ | ″ | response |
157 | ″ | ″ | results |
158 | ″ | ″ | retrospective trials |
159 | ″ | ″ | review |
160 | ″ | ″ | ritonavir |
161 | ″ | ″ | ruxolitinib |
162 | ″ | ″ | sarilumab |
163 | ″ | ″ | scholars |
164 | ″ | ″ | search |
165 | ″ | ″ | series |
166 | ″ | ″ | significant reduction |
167 | ″ | ″ | siltuximab |
168 | ″ | ″ | stage |
169 | ″ | ″ | study |
170 | ″ | ″ | supportive therapy |
171 | ″ | ″ | syndrome |
172 | ″ | ″ | systematic review |
173 | ″ | ″ | therapeutic agents |
174 | ″ | ″ | therapeutic approaches |
175 | ″ | ″ | therapy |
176 | ″ | ″ | time |
177 | ″ | ″ | tocilizumab |
178 | ″ | ″ | treatment |
179 | ″ | ″ | trial of tocilizumab |
180 | ″ | ″ | trials |
181 | ″ | ″ | unit admission |
182 | ″ | ″ | use |
183 | ″ | ″ | use of remdesivir |
184 | ″ | schema:name | Immune Therapy, or Antiviral Therapy, or Both for COVID-19: A Systematic Review |
185 | ″ | schema:pagination | 1929-1946 |
186 | ″ | schema:productId | N46904a6e640c4177b191ff8b79da5280 |
187 | ″ | ″ | Nd7cef85f1a5943c0b0a64e5a7d46c9aa |
188 | ″ | ″ | Nfb223406c4cb40cf96d67b6fa331ed5a |
189 | ″ | schema:sameAs | https://app.dimensions.ai/details/publication/pub.1131847400 |
190 | ″ | ″ | https://doi.org/10.1007/s40265-020-01421-w |
191 | ″ | schema:sdDatePublished | 2022-05-10T10:27 |
192 | ″ | schema:sdLicense | https://scigraph.springernature.com/explorer/license/ |
193 | ″ | schema:sdPublisher | N8e5c979976fa40f7bb4a295051365785 |
194 | ″ | schema:url | https://doi.org/10.1007/s40265-020-01421-w |
195 | ″ | sgo:license | sg:explorer/license/ |
196 | ″ | sgo:sdDataset | articles |
197 | ″ | rdf:type | schema:ScholarlyArticle |
198 | N056ec2cb34684539ae3c0314401df835 | rdf:first | sg:person.01326370162.46 |
199 | ″ | rdf:rest | N6a6b85186c3c4a19b79a9cd1f89ce3c5 |
200 | N0de2275bf2704e43bc28a751468e44d9 | schema:issueNumber | 18 |
201 | ″ | rdf:type | schema:PublicationIssue |
202 | N100e8d3c21d14098978654b325d4524b | rdf:first | sg:person.0755160366.91 |
203 | ″ | rdf:rest | N056ec2cb34684539ae3c0314401df835 |
204 | N2bfd0e5f9dc84492be672a466a81b4df | schema:inDefinedTermSet | https://www.nlm.nih.gov/mesh/ |
205 | ″ | schema:name | Pandemics |
206 | ″ | rdf:type | schema:DefinedTerm |
207 | N44bb2fe2a2814aafbfd77a3cb4992ab4 | rdf:first | sg:person.01212617510.19 |
208 | ″ | rdf:rest | Nf8cdf374c27d4224b395a32fd61faefe |
209 | N46904a6e640c4177b191ff8b79da5280 | schema:name | pubmed_id |
210 | ″ | schema:value | 33068263 |
211 | ″ | rdf:type | schema:PropertyValue |
212 | N56797668da0648e384751a930b41f6a3 | schema:inDefinedTermSet | https://www.nlm.nih.gov/mesh/ |
213 | ″ | schema:name | Inflammation Mediators |
214 | ″ | rdf:type | schema:DefinedTerm |
215 | N5ab3f8611e26424dac51fe5f4ce7c10e | schema:inDefinedTermSet | https://www.nlm.nih.gov/mesh/ |
216 | ″ | schema:name | Drug Therapy, Combination |
217 | ″ | rdf:type | schema:DefinedTerm |
218 | N619239a0c67c4d579c26a1de40c33168 | schema:inDefinedTermSet | https://www.nlm.nih.gov/mesh/ |
219 | ″ | schema:name | Humans |
220 | ″ | rdf:type | schema:DefinedTerm |
221 | N64c133cd80b9458780182615fd85b010 | schema:inDefinedTermSet | https://www.nlm.nih.gov/mesh/ |
222 | ″ | schema:name | Alanine |
223 | ″ | rdf:type | schema:DefinedTerm |
224 | N6a6b85186c3c4a19b79a9cd1f89ce3c5 | rdf:first | sg:person.01145652405.31 |
225 | ″ | rdf:rest | Na55bea3743884db486d96492bfdfcef4 |
226 | N78288e1be1414888806af8837a23ff54 | schema:inDefinedTermSet | https://www.nlm.nih.gov/mesh/ |
227 | ″ | schema:name | Adenosine Monophosphate |
228 | ″ | rdf:type | schema:DefinedTerm |
229 | N80eebbf0cfe74e399e77934870b16f8b | schema:volumeNumber | 80 |
230 | ″ | rdf:type | schema:PublicationVolume |
231 | N8bf3bfcec3464acab821899657b128c1 | schema:inDefinedTermSet | https://www.nlm.nih.gov/mesh/ |
232 | ″ | schema:name | Anti-Inflammatory Agents |
233 | ″ | rdf:type | schema:DefinedTerm |
234 | N8e20384481cb40b9946efcb6d022657a | schema:inDefinedTermSet | https://www.nlm.nih.gov/mesh/ |
235 | ″ | schema:name | Biological Products |
236 | ″ | rdf:type | schema:DefinedTerm |
237 | N8e5c979976fa40f7bb4a295051365785 | schema:name | Springer Nature - SN SciGraph project |
238 | ″ | rdf:type | schema:Organization |
239 | N90d1ec1aa94f45dba5d58dfe9a7569d1 | schema:inDefinedTermSet | https://www.nlm.nih.gov/mesh/ |
240 | ″ | schema:name | Antibodies, Monoclonal, Humanized |
241 | ″ | rdf:type | schema:DefinedTerm |
242 | N9a81e6c389e44dbd8ed34b9355ffa83f | schema:inDefinedTermSet | https://www.nlm.nih.gov/mesh/ |
243 | ″ | schema:name | COVID-19 |
244 | ″ | rdf:type | schema:DefinedTerm |
245 | N9bdeca9df17945ef8de12e186409f978 | schema:inDefinedTermSet | https://www.nlm.nih.gov/mesh/ |
246 | ″ | schema:name | Antiviral Agents |
247 | ″ | rdf:type | schema:DefinedTerm |
248 | Na55bea3743884db486d96492bfdfcef4 | rdf:first | sg:person.01135302217.49 |
249 | ″ | rdf:rest | rdf:nil |
250 | Nad41b01c4eab4c379926dbbe3869a3f6 | schema:inDefinedTermSet | https://www.nlm.nih.gov/mesh/ |
251 | ″ | schema:name | Cytokines |
252 | ″ | rdf:type | schema:DefinedTerm |
253 | Nc535e9288c8f42f487596bbeb95b1aee | schema:inDefinedTermSet | https://www.nlm.nih.gov/mesh/ |
254 | ″ | schema:name | Intensive Care Units |
255 | ″ | rdf:type | schema:DefinedTerm |
256 | Nd239640e87444894942bf859c5274751 | schema:inDefinedTermSet | https://www.nlm.nih.gov/mesh/ |
257 | ″ | schema:name | SARS-CoV-2 |
258 | ″ | rdf:type | schema:DefinedTerm |
259 | Nd7cef85f1a5943c0b0a64e5a7d46c9aa | schema:name | dimensions_id |
260 | ″ | schema:value | pub.1131847400 |
261 | ″ | rdf:type | schema:PropertyValue |
262 | Nf338409e95b64351bfb0bf3f139f5f1e | schema:inDefinedTermSet | https://www.nlm.nih.gov/mesh/ |
263 | ″ | schema:name | Dexamethasone |
264 | ″ | rdf:type | schema:DefinedTerm |
265 | Nf8cdf374c27d4224b395a32fd61faefe | rdf:first | sg:person.01200446072.99 |
266 | ″ | rdf:rest | N100e8d3c21d14098978654b325d4524b |
267 | Nfb223406c4cb40cf96d67b6fa331ed5a | schema:name | doi |
268 | ″ | schema:value | 10.1007/s40265-020-01421-w |
269 | ″ | rdf:type | schema:PropertyValue |
270 | Nfc290dbfc95f4983aad6bc0b09d16176 | schema:inDefinedTermSet | https://www.nlm.nih.gov/mesh/ |
271 | ″ | schema:name | Retrospective Studies |
272 | ″ | rdf:type | schema:DefinedTerm |
273 | anzsrc-for:11 | schema:inDefinedTermSet | anzsrc-for: |
274 | ″ | schema:name | Medical and Health Sciences |
275 | ″ | rdf:type | schema:DefinedTerm |
276 | anzsrc-for:1103 | schema:inDefinedTermSet | anzsrc-for: |
277 | ″ | schema:name | Clinical Sciences |
278 | ″ | rdf:type | schema:DefinedTerm |
279 | sg:journal.1084788 | schema:issn | 0012-6667 |
280 | ″ | ″ | 1179-1950 |
281 | ″ | schema:name | Drugs |
282 | ″ | schema:publisher | Springer Nature |
283 | ″ | rdf:type | schema:Periodical |
284 | sg:person.01135302217.49 | schema:affiliation | grid-institutes:grid.412844.f |
285 | ″ | schema:familyName | Foti |
286 | ″ | schema:givenName | Rosario |
287 | ″ | schema:sameAs | https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01135302217.49 |
288 | ″ | rdf:type | schema:Person |
289 | sg:person.01145652405.31 | schema:affiliation | grid-institutes:grid.430148.a |
290 | ″ | schema:familyName | Niccoli |
291 | ″ | schema:givenName | Laura |
292 | ″ | schema:sameAs | https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01145652405.31 |
293 | ″ | rdf:type | schema:Person |
294 | sg:person.01200446072.99 | schema:affiliation | grid-institutes:grid.419423.9 |
295 | ″ | schema:familyName | Goletti |
296 | ″ | schema:givenName | Delia |
297 | ″ | schema:sameAs | https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01200446072.99 |
298 | ″ | rdf:type | schema:Person |
299 | sg:person.01212617510.19 | schema:affiliation | grid-institutes:grid.430148.a |
300 | ″ | schema:familyName | Cantini |
301 | ″ | schema:givenName | Fabrizio |
302 | ″ | schema:sameAs | https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01212617510.19 |
303 | ″ | rdf:type | schema:Person |
304 | sg:person.01326370162.46 | schema:affiliation | grid-institutes:grid.419423.9 |
305 | ″ | schema:familyName | Najafi Fard |
306 | ″ | schema:givenName | Saied |
307 | ″ | schema:sameAs | https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01326370162.46 |
308 | ″ | rdf:type | schema:Person |
309 | sg:person.0755160366.91 | schema:affiliation | grid-institutes:grid.419423.9 |
310 | ″ | schema:familyName | Petrone |
311 | ″ | schema:givenName | Linda |
312 | ″ | schema:sameAs | https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0755160366.91 |
313 | ″ | rdf:type | schema:Person |
314 | sg:pub.10.1007/s00296-020-04603-7 | schema:sameAs | https://app.dimensions.ai/details/publication/pub.1127647339 |
315 | ″ | ″ | https://doi.org/10.1007/s00296-020-04603-7 |
316 | ″ | rdf:type | schema:CreativeWork |
317 | sg:pub.10.1007/s12250-020-00207-4 | schema:sameAs | https://app.dimensions.ai/details/publication/pub.1125334309 |
318 | ″ | ″ | https://doi.org/10.1007/s12250-020-00207-4 |
319 | ″ | rdf:type | schema:CreativeWork |
320 | sg:pub.10.1038/s41375-020-0848-3 | schema:sameAs | https://app.dimensions.ai/details/publication/pub.1127377041 |
321 | ″ | ″ | https://doi.org/10.1038/s41375-020-0848-3 |
322 | ″ | rdf:type | schema:CreativeWork |
323 | sg:pub.10.1038/s41392-020-0191-1 | schema:sameAs | https://app.dimensions.ai/details/publication/pub.1127986286 |
324 | ″ | ″ | https://doi.org/10.1038/s41392-020-0191-1 |
325 | ″ | rdf:type | schema:CreativeWork |
326 | sg:pub.10.1038/s41467-020-17240-2 | schema:sameAs | https://app.dimensions.ai/details/publication/pub.1129065459 |
327 | ″ | ″ | https://doi.org/10.1038/s41467-020-17240-2 |
328 | ″ | rdf:type | schema:CreativeWork |
329 | sg:pub.10.1038/s41577-020-0328-z | schema:sameAs | https://app.dimensions.ai/details/publication/pub.1127257736 |
330 | ″ | ″ | https://doi.org/10.1038/s41577-020-0328-z |
331 | ″ | rdf:type | schema:CreativeWork |
332 | sg:pub.10.1038/s41586-020-2012-7 | schema:sameAs | https://app.dimensions.ai/details/publication/pub.1124545162 |
333 | ″ | ″ | https://doi.org/10.1038/s41586-020-2012-7 |
334 | ″ | rdf:type | schema:CreativeWork |
335 | sg:pub.10.1038/s41591-020-0817-4 | schema:sameAs | https://app.dimensions.ai/details/publication/pub.1125618973 |
336 | ″ | ″ | https://doi.org/10.1038/s41591-020-0817-4 |
337 | ″ | rdf:type | schema:CreativeWork |
338 | sg:pub.10.1038/s41591-020-0869-5 | schema:sameAs | https://app.dimensions.ai/details/publication/pub.1126655280 |
339 | ″ | ″ | https://doi.org/10.1038/s41591-020-0869-5 |
340 | ″ | rdf:type | schema:CreativeWork |
341 | grid-institutes:grid.412844.f | schema:alternateName | Rheumatology Unit, Vittorio-Emanuele University Hospital of Catania, Catania, Italy |
342 | ″ | schema:name | Rheumatology Unit, Vittorio-Emanuele University Hospital of Catania, Catania, Italy |
343 | ″ | rdf:type | schema:Organization |
344 | grid-institutes:grid.419423.9 | schema:alternateName | Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy |
345 | ″ | schema:name | Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy |
346 | ″ | rdf:type | schema:Organization |
347 | grid-institutes:grid.430148.a | schema:alternateName | Department of Rheumatology, Azienda USL Toscana Centro, Hospital of Prato, Prato, Italy |
348 | ″ | schema:name | Department of Rheumatology, Azienda USL Toscana Centro, Hospital of Prato, Prato, Italy |
349 | ″ | rdf:type | schema:Organization |