A Comprehensive Summary of the Knowledge on COVID-19 Treatment

Peng, Yu; Tao, Hongxun; Satyanarayanan, Senthil Kumaran; Jin, Kunlin; Su, Huanxing

doi:10.14336/ad.2020.1124

Cited by 34 publications

(29 citation statements)

References 224 publications

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“…Although with little specific therapeutic indication for COVID-19, several drugs in clinical use for other disorders have been administered to patients infected with SARS-CoV-2 (for extensive reviews, see [3,4]). Many of these therapeutics belong to the class of antiviral agents, such as Remdesivir (a broad-spectrum pro-drug agent acting as a viral RNA-polymerase inhibitor), the combination Lopinavir/Ritonavir (HIV-1 protease inhibitors, which are together more efficient compared to the monotherapy of each drug), and Sofosbuvir (a nucleotide analogue targeting the hepatitis C virus (HCV) polymerase NS5B) in combination with Daclatasvir or Velpatasvir (both are potent HCV NS5A complex antagonists).…”

Section: Introductionmentioning

confidence: 99%

Rutin Is a Low Micromolar Inhibitor of SARS-CoV-2 Main Protease 3CLpro: Implications for Drug Design of Quercetin Analogs

et al. 2021

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The pandemic, due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has stimulated the search for antivirals to tackle COVID-19 infection. Molecules with known pharmacokinetics and already approved for human use have been demonstrated or predicted to be suitable to be used either directly or as a base for a scaffold-based drug design. Among these substances, quercetin is known to be a potent in vitro inhibitor of 3CLpro, the SARS-CoV-2 main protease. However, its low in vivo bioavailability calls for modifications to its molecular structure. In this work, this issue is addressed by using rutin, a natural flavonoid that is the most common glycosylated conjugate of quercetin, as a model. Combining experimental (spectroscopy and calorimetry) and simulation techniques (docking and molecular dynamics simulations), we demonstrate that the sugar adduct does not hamper rutin binding to 3CLpro, and the conjugated compound preserves a high potency (inhibition constant in the low micromolar range, Ki = 11 μM). Although showing a disruption of the pseudo-symmetry in the chemical structure, a larger steric volume and molecular weight, and a higher solubility compared to quercetin, rutin is able to associate in the active site of 3CLpro, interacting with the catalytic dyad (His41/Cys145). The overall results have implications in the drug-design of quercetin analogs, and possibly other antivirals, to target the catalytic site of the SARS-CoV-2 3CLpro.

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Section: Introductionmentioning

confidence: 99%

Rutin Is a Low Micromolar Inhibitor of SARS-CoV-2 Main Protease 3CLpro: Implications for Drug Design of Quercetin Analogs

et al. 2021

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“…The recommendations for the care of COVID-19 patients vary widely, especially during the early months of the pandemic, between the different countries around the world. While there is no approved medication for COVID-19, the general guidance is to provide supportive management as per the needs of each patient, for instance, the saturated O 2 (particularly in patients with SpO2 lower than 90%), the immune-boosters (such as vitamins C and D and zinc), and the antipyretics (such as acetaminophen) for fever [8]. To counteract the vicious pandemic, numerous clinicians and scientists around the globe suggested the use of different medications that are believed to have a potential antiviral action against the COVID-19 virus, such as hydroxychloroquine, favipiravir, remdesivir, or azithromycin [8,9].…”

Section: Introductionmentioning

confidence: 99%

“…While there is no approved medication for COVID-19, the general guidance is to provide supportive management as per the needs of each patient, for instance, the saturated O 2 (particularly in patients with SpO2 lower than 90%), the immune-boosters (such as vitamins C and D and zinc), and the antipyretics (such as acetaminophen) for fever [8]. To counteract the vicious pandemic, numerous clinicians and scientists around the globe suggested the use of different medications that are believed to have a potential antiviral action against the COVID-19 virus, such as hydroxychloroquine, favipiravir, remdesivir, or azithromycin [8,9]. On the other hand, mounting evidence was suggesting that patients with a rapidly deteriorating condition might be suffering from a severe autoimmune reaction.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the Pharmacologic Treatment of COVID-19 Pandemic in Iraq

et al. 2021

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The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, or COVID-19) has been detrimental to human health, economy, and wellbeing. Little information is known on the epidemiology and outcome of the disease in a localized community within Iraq. We carried out an audit of confirmed cases of COVID-19 in the Kirkuk General Hospital. Data from the 20th of June to the 31st of July, 2020, were collected and analyzed. Suspected COVID-19 cases were confirmed by real-time polymerase chain reaction (RT-PCR). Data on clinical symptoms, age, and treatment protocols were analyzed concerning the outcome. Our study included a total of 200 individual confirmed COVID-19 patients. The majority of cases 55% (n = 110) displayed severe symptoms, while 32.5% (65 cases) and 12.5% (25 cases) of patients displayed moderate to mild symptoms, respectively. The rate of death in the referred patients was 5%. Most patients admitted to the hospital for treatment recovered and were discharged from the hospital within 5 to 30 days post-diagnosis. Statistical analysis revealed that patients treated with oseltamivir, hydroxychloroquine, and azithromycin in combination with vitamins C and D have shorter hospital stay compared to patients receiving the same therapeutic protocol in combination with steroids. Moreover, a higher mortality rate (4.5%) was observed in patients treated with oseltamivir, hydroxychloroquine, ceftriaxone, and steroids. This study highlights a significant relationship between age, secondary ailments, and the choice of medications as simple predictors of the outcome of COVID-19.

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“…Based on TCM theory, cold-dampness is the pathogenesis of COVID-19 [ 53 ]. Cold-dampness attacks the surface of the lung and closes it, trapping the spleen, and injuring Yang.…”

Section: Discussionmentioning

confidence: 99%