Updated COVID-19 Pharmacotherapy in Different Diseases Such as Cancer

Abstract

Studies suggest that cancer is a main complication regarding life expectancy and a foremost reason for death worldwide. For the treatment of COVID-19 infected 703,525,337 cases with 6,984,801 deaths worldwide up to February 21, 2024, well-designed pharmacotherapy management in different diseases, such as cancer, is respected. This investigation aims to review the current accessible medical treatment for patients with different diseases, cancer, and COVID-19. The appropriate documents for this review were achieved by searching databases such as Web of Science, Scopus, and PUBMED. Relevant studies included in review articles, clinical trials, and case reports that were evaluated and used (n=109 articles). In those with cancer and COVID-19, publications reported worsened clinical conditions with a considerably higher risk of death. The result of existing regular antitumor management could be a basis of debate. In the general population, asymptomatic patients with positive nasopharyngeal swabs are recommended to receive antibiotic prophylaxis, and in those with symptomatic signs, adjustment of angiotensin-converting enzyme based on anti-hypertensive therapy should be considered. In patients with liver disease, nitazoxanide plus sofosbuvir, ivermectin, tocilizumab, convalescent plasma, and low molecular weight heparin in certain situations is recommended. Furthermore, favipiravir, chloroquine, and hydroxychloroquine could also be recommended, but with caution regarding to polypharmacy interactions. For those with moderate disease, hydroxychloroquine or chloroquine/ azithromycin was recommended. In the patients with respiratory failure, convalescent plasma was suggested. In the populations where those symptoms progress to the sign of a cytokine storm, the antagonists of interleukin-6 (IL-6) were suggested. To reduce fever, however, ibuprofen showed more potent efficacy compared to acetaminophen, but it may delay the benefits of a fever response. Owing to the immune suppression that could be caused by anti-cancer drugs and deterioration of lung functions due to COVID-19, for proposed management regarding pharmacotherapy strategies, further evidence-based studies seem to be advantageous.