Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus causing coronavirus disease 2019 (COVID-19), which has been a global pandemic since March 2020. According to WHO, more than 289 million cases have been confirmed worldwide, with just over 5.4 million reported deaths as of January 2022.

COVID-19 infections may be asymptomatic in some cases, while most cases cause mild to moderate illness with respiratory and flu-like symptoms. However, some COVID-19 cases develop severe life-threatening illness involving severe pneumonia and acute respiratory distress syndrome (ARDS), requiring admission to the intensive care unit (ICU).

ARDS is a life-threatening condition in which the lungs are severely inflamed with tissue damage throughout, which causes injury to alveoli and fluid leak in pulmonary blood vessels. According to the American Lung Association, ARDS is a common cause of death among mechanically ventilated COVID-19 patients.

Most critically ill COVID-19 patients will require hemodynamic stability because no direct treatment is available for ARDS management. Hence, there is an urgent need for a therapeutic agent to provide hemodynamic stability and improve ARDS, MODS, and survival of patients infected with COVID-19.

At present, there is no widely accepted standard of care regarding pharmacotherapy of patients with COVID-19; however, research has been vigorous and ongoing. As a result, various therapies have been issued an Emergency Use Authorization and are implemented in the treatment guidelines for COVID 19 by the National Institute of Health.

Although there have been breakthroughs in the treatment for COVID-19, most of these are directed at mild-to-moderate disease rather than patients with a severe disease on mechanical ventilators. There is still a need for novel and effective treatment options in severe COVID-19 illness with continued vaccine hesitancy, decreased social distancing, and new emerging variants.

Centhaquine is a first-in-class resuscitative agent for the hypovolemic shock that is approved for marketing in India. Centhaquine provided hemodynamic stability and significantly improved acute respiratory distress syndrome (ARDS) and multiple organ dysfunction score (MODS) in clinical trials conducted in 155 patients with hypovolemic shock.