Field Of Vision
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Meta-Anal. Jun 28, 2020; 8(3): 173-177
Published online Jun 28, 2020. doi: 10.13105/wjma.v8.i3.173
COVID-19: Off-label therapies based on mechanism of action while waiting for evidence-based medicine recommendations
Matteo Scotto Di Vetta, Marco Morrone, Serafino Fazio
Matteo Scotto Di Vetta, Department of Internal Medicine, University of Naples, Naples 80100, Italy
Marco Morrone, Farmacia, Farmacia Morrone, Casoria 80022, Italy
Serafino Fazio, Department of Internal Medicine, Cardiovascular and Immunologic Sciences, Federico II University of Naples, Napoli 80100, Italy
Author contributions: Scotto Di Vetta M, Morrone M and Fazio S contributed to the writing of the manuscript.
Conflict-of-interest statement: No conflict of interest.
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: Serafino Fazio, MD, Adjunct Professor, Associate Specialist, Department of Internal Medicine, Cardiovascular and Immunologic Sciences, Federico II University of Naples, Via S. Pansini 5, Napoli 80100, Italy. sefazio@libero.it
Received: May 18, 2020
Peer-review started: May 18, 2020
First decision: June 8, 2020
Revised: June 8, 2020
Accepted: June 28, 2020
Article in press: June 28, 2020
Published online: June 28, 2020
Processing time: 49 Days and 17.7 Hours
Abstract

The world pandemic due to coronavirus disease 2019, known as COVID-19, embodies a high rate of disease transmission that causes a critical hospitalization overload. As of May 15, 2020, the disease has been the cause of more than 4 million infections and more than 280000 deaths all over the world. At the beginning, we underestimated the disease; now, we have sufficient information and it is clear that it is not just a respiratory disease. In fact, if a prompt treatment is not initiated, the disease may evolve towards an abnormal immune response and cytokine storm with an important thrombophilic pattern. Therefore, we think that while waiting for certainties to be established by evidence-based medicine, it is not ethical to not try off-label therapies for some of the well-known drugs, as they could have some efficacy based on their mechanisms of action.

Keywords: COVID-19; Evidence based medicine; Hydroxycloroquine; Azithromycine; Indomethacine; Doxycycline

Core tip: The world pandemic due to coronavirus disease 2019, known as COVID-19, embodies a high rate of disease transmission that has caused a critical hospitalization overload. While waiting for certainties to be established by evidence-based medicine, it is not ethical to not try off-label therapies with some of the well-known drugs that could show some efficacy based on their mechanisms of action.