Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19): A Review

JAMA. 2020 May 12;323(18):1824-1836. doi: 10.1001/jama.2020.6019.


Importance: The pandemic of coronavirus disease 2019 (COVID-19) caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) presents an unprecedented challenge to identify effective drugs for prevention and treatment. Given the rapid pace of scientific discovery and clinical data generated by the large number of people rapidly infected by SARS-CoV-2, clinicians need accurate evidence regarding effective medical treatments for this infection.

Observations: No proven effective therapies for this virus currently exist. The rapidly expanding knowledge regarding SARS-CoV-2 virology provides a significant number of potential drug targets. The most promising therapy is remdesivir. Remdesivir has potent in vitro activity against SARS-CoV-2, but it is not US Food and Drug Administration approved and currently is being tested in ongoing randomized trials. Oseltamivir has not been shown to have efficacy, and corticosteroids are currently not recommended. Current clinical evidence does not support stopping angiotensin-converting enzyme inhibitors or angiotensin receptor blockers in patients with COVID-19.

Conclusions and relevance: The COVID-19 pandemic represents the greatest global public health crisis of this generation and, potentially, since the pandemic influenza outbreak of 1918. The speed and volume of clinical trials launched to investigate potential therapies for COVID-19 highlight both the need and capability to produce high-quality evidence even in the middle of a pandemic. No therapies have been shown effective to date.

Publication types

  • Review

MeSH terms

  • Adenosine Monophosphate / analogs & derivatives
  • Adenosine Monophosphate / therapeutic use
  • Adrenal Cortex Hormones / therapeutic use
  • Alanine / analogs & derivatives
  • Alanine / therapeutic use
  • Amides / therapeutic use
  • Angiotensin Receptor Antagonists / therapeutic use
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Antiviral Agents / therapeutic use*
  • Azithromycin / therapeutic use
  • Betacoronavirus* / drug effects
  • Betacoronavirus* / physiology
  • COVID-19
  • COVID-19 Drug Treatment
  • Chloroquine / therapeutic use
  • Coronavirus Infections / drug therapy*
  • Coronavirus Infections / epidemiology
  • Humans
  • Hydroxychloroquine / therapeutic use
  • Immunoglobulins / therapeutic use
  • Immunologic Factors / therapeutic use
  • Indoles / therapeutic use
  • Lopinavir / therapeutic use
  • Oseltamivir / therapeutic use
  • Pandemics
  • Pneumonia, Viral / drug therapy*
  • Pneumonia, Viral / epidemiology
  • Pyrazines / therapeutic use
  • Ribavirin / therapeutic use
  • Ritonavir / therapeutic use
  • SARS-CoV-2
  • Withholding Treatment


  • Adrenal Cortex Hormones
  • Amides
  • Angiotensin Receptor Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Antiviral Agents
  • Immunoglobulins
  • Immunologic Factors
  • Indoles
  • Pyrazines
  • Oseltamivir
  • Lopinavir
  • remdesivir
  • Adenosine Monophosphate
  • Ribavirin
  • Hydroxychloroquine
  • Azithromycin
  • Chloroquine
  • umifenovir
  • favipiravir
  • Ritonavir
  • Alanine