Systematic Reviews
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 6, 2021; 9(19): 5135-5178
Published online Jul 6, 2021. doi: 10.12998/wjcc.v9.i19.5135
Controversies’ clarification regarding ribavirin efficacy in measles and coronaviruses: Comprehensive therapeutic approach strictly tailored to COVID-19 disease stages
George D Liatsos
George D Liatsos, Department of Internal Medicine, "Hippokration" General Hospital, Athens 11527, Attiki, Greece
Author contributions: Liatsos GD designed the report, collected and analyzed the data, and wrote and revised the paper.
Conflict-of-interest statement: The authors declare no conflicts of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: George D Liatsos, MD, PhD, Chief Doctor, Department of Internal Medicine, "Hippokration" General Hospital, 114 Vass. Sophia’s Ave, Athens 11527, Attiki, Greece. geoliatsos@yahoo.gr
Received: November 8, 2020
Peer-review started: November 8, 2020
First decision: December 21, 2020
Revised: January 1, 2021
Accepted: May 20, 2021
Article in press: May 20, 2021
Published online: July 6, 2021
Core Tip

Core Tip: Documented by accumulated data from coronaviruses studies and considering six identified pitfalls to which most of the studies fall victim, the early antiviral treatment is crucial for reducing viral load, transmission, and preventing disease severity. In coronavirus disease 2019, initiation of interferon-β plus ribavirin plus lopinavir/ritonavir is beneficial when targeting selected patients early during Stage I, and is a regimen that can be administered while the patient is at home in quarantine. If disease progresses to Stages IIb-III, corticosteroids (mainly pulsed methylprednisolone) are effective, but if they fail or extrapulmonary systemic hyperinflammation syndrome develops, tocilizumab (or anakinra) should be co-administered.