Treatment of SARS-CoV-2 (COVID-19): A safety perspective

Table 2 Common adverse reaction of immunomodulators used in treatment of COVID-19

Drug	Class	Adverse effects
Anakinra	Interleukin 1 inhibitor	Abdominal pain; anaphylaxis; elevated liver enzymes; flu-like symptoms; headache; local reactions; nausea/vomiting/diarrhea; neutropenia; sinusitis
Canakinumab	Anti-interleukin 1β monoclonal antibody	Abdominal pain; elevated liver enzymes; flu-like symptoms; hematologic cytopenias; hypersensitivity reactions; local reactions; nausea/vomiting/diarrhea; sinusitis
Dexamethasone	Corticosteroid	Bone loss; edema/weight gain; hyperglycemia; hypernatremia; hypertension; myopathy; neuropsychiatric disturbance; peptic ulcer disease; reactivation of latent infections (i.e., TB or strongyloidosis); secondary infections; venous thromboembolism
Interferon-α	Interferon	Elevated liver functions; flu-like symptoms; hematological cytopeniaInfusion reaction; local reaction; nausea/vomiting; neuropsychiatric disease
Interferon-β	Interferon	Elevated liver functions; flu-like symptoms; hematological cytopeniaInfusion reaction; local reaction; nausea/vomiting; neuropsychiatric disease
Siltuximab	Anti-interleukin 6 monoclonal antibody	Elevated liver enzymes; gastrointestinal perforation; headache/dizziness; hyperuricemia; hypersensitivity reaction; neutropenia; pruritis/rash; reactivation of latent infection (i.e., HBV); secondary infections
Sirulimab	Anti-interleukin 6 Receptor monoclonal antibody	Elevated liver enzymes; gastrointestinal perforation; hypersensitivity reaction; neutropenia; reactivation of latent infection (i.e., HBV); secondary infections
Tocilizumab	Anti-interleukin 6 Receptor monoclonal antibody	Elevated liver enzymes; gastrointestinal perforation; changes in platelets and lipids; hypersensitivity reaction; neutropenia; reactivation of latent infection (i.e., HBV); secondary infections

TB: Tuberculosis; HBV: Hepatitis B virus.