Pharmaceutical situation of the pharmacological treatment of hospitalized patients with COVID-19 in Libya

By January 2020, severe acute respiratory syndrome coronavirus-2 has spread internationally to a pandemic that mainly targets the respiratory system. The relevant infectious disease has been identified as coronavirus disease-2019 (COVID-19) by World Health Organization and declared as a global pandemic. In Libya, National Center for Disease Control reported the first case of coronavirus disease-2019 on 24^th March, 2020. The authorities decided to close borders and activate designated treatment centers to deal with COVID-19 cases and contain the outbreak of SARS-COV-2. This study aimed to assess and evaluate the pharmaceutical situation of medications used in pharmacological management of hospitalized COVID-19 patients in Tripoli, Libya. Three WHO availability indicators were selected to be studied and reported. A comprehensive list of medicines used in the management of hospitalized COVID-19 patients was constructed after reviewing and comparing seven national and international pharmacological management protocols and guidelines for hospitalized COVID-19 patients. This comparison revealed that nearly 50 medications are intended for use in COVID-19 inpatient pharmacological management. They all agreed about the use of three medications, representing one from each main class. This list was used to cross check their availability at the chosen designated COVID-19 treatment center. This study proved that local treatment center’s protocol is more in line with international guidelines than the national treatment guideline. The later was issued on March 2020. The Libyan National Essential Medicines’ List contained 25 out of 50 medications of the comprehensive list based on the last update in April 2019. This study recommends that national treatment guidelines and National Essential Medicines’ list require updating.  Not all medications used in COVID-19 inpatient management were available in local treatment centers, although, the Emergency Management Department of Ministry of Health in Libya is responsible for the supply of the required medical supplies and medications to the COVID-19 treatment centers.