Key Points
We report the first case of coronavirus disease 2019 (COVID-19) in a multiple myeloma patient successfully treated with tocilizumab. Although tocilizumab was effective in the treatment of COVID-19 in this case, randomized controlled trials are needed.
The
outbreak of coronavirus disease 2019 (COVID-19) caused by severe
acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has emphasized
the urgency to develop effective therapeutics. Drug repurposing screening
is regarded as one of the most practical and rapid approaches for
the discovery of such therapeutics. The 3C-like protease (3CL
pro
), or main protease (M
pro
) of SARS-CoV-2 is a
valid drug target as it is a specific viral enzyme and plays an essential
role in viral replication. We performed a quantitative high-throughput
screening (qHTS) of 10 755 compounds consisting of approved
and investigational drugs, and bioactive compounds using a SARS-CoV-2
3CL
pro
assay. Twenty-three small molecule inhibitors of
SARS-CoV-2 3CL
pro
have been identified with IC
50
s ranging from 0.26 to 28.85 μM. Walrycin B (IC
50
= 0.26 μM), hydroxocobalamin (IC
50
= 3.29 μM),
suramin sodium (IC
50
= 6.5 μM), Z-DEVD-FMK (IC
50
= 6.81 μM), LLL-12 (IC
50
= 9.84 μM),
and Z-FA-FMK (IC
50
= 11.39 μM) are the most potent
3CL
pro
inhibitors. The activity of the anti-SARS-CoV-2
viral infection was confirmed in 7 of 23 compounds using a SARS-CoV-2
cytopathic effect assay. The results demonstrated a set of SARS-CoV-2
3CL
pro
inhibitors that may have potential for further clinical
evaluation as part of drug combination therapies to treating COVID-19
patients and as starting points for chemistry optimization for new
drug development.
Coronavirus disease , caused by a novel betacoronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly developed into a pandemic since it was first reported in December 2019. Nucleic acid testing is the standard method for the diagnosis of viral infections. However, this method reportedly has a low positivity rate. To increase the sensitivity of COVID-19 diagnoses, we developed an IgM-IgG combined assay and tested it in patients with suspected SARS-CoV-2 infection. In total, 56 patients were enrolled in this study and SARS-CoV-2 was detected by using both IgM-IgG antibody and nucleic acid tests. Clinical and laboratory data were collected and analyzed. Our findings suggest that patients who develop severe illness might experience longer virus exposure times and develop a more severe inflammatory response. The IgM-IgG test is an accurate and sensitive diagnostic method. A combination of nucleic acid and IgM-IgG testing is a more sensitive and accurate approach for diagnosis and early treatment of COVID-19.
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