7.4  Combination therapy
Combination therapy is a more extensive and rigorous approach mainly aimed at correction of life‐threatening events such as shock, hypoxemia, secondary or super infection, and maintenance of homeostasis, that is, electrolyte, acid and base balance. As a palliative practice, antiviral treatment in the early stages of COVID‐19 might lessen the severity and prevent further progression of the disease. Trials on combination therapy with lopinavir/ritonavir and arbidol (umifenovir) have reported satisfactory results in treatment of COVID‐19. Alongside a proper antiviral treatment, patients may also benefit from an artificial liver blood purification system, which is capable of rapidly removing the inflammatory factors from blood, thus, halting the disastrous cytokine release syndrome. This system can also facilitate the sustenance of critically ill patients by preserving the balance of bodily fluid. Administration of glucocorticoids in moderate doses is another intervention that has recently been indicated for patients with severe COVID‐19‐associated pneumonia. However, secondary fungal infection should be considered. Patients with an oxygenation index of less than 200 mmHg might benefit more from oxygen therapy than noninvasive ventilation. A rational prescription of antimicrobial medicines has been cautioned only for patients with remittent fever and elevated antimicrobial prophylaxis should be prescribed rationally and was not recommended except for patients with long course of disease, repeated fever, and elevated PCT levels. Ultimately, to maintain the balance of intestinal microbiota, oral intake of prebiotics or probiotics has been suggested. This can reduce the risk of secondary infections as a result of microbial translocation; however, effectiveness of such interventions on postinfection clearance pattern of SARS‐CoV‐2 has not been studied (Xu et al., 2020).