A Review of SARS-CoV-2 and the Ongoing Clinical Trials

Abstract

The sudden outbreak of 2019 novel coronavirus (2019-nCoV, later named SARS-CoV-2) in Wuhan, China, which rapidly grew into a global pandemic, marked the third introduction of a virulent coronavirus into the human society, affecting not only the healthcare system, but also the global economy. Although our understanding of coronaviruses has undergone a huge leap after two precedents, the effective approaches to treatment and epidemiological control are still lacking. In this article, we present a succinct overview of the epidemiology, clinical features, and molecular characteristics of SARS-CoV-2. We summarize the current epidemiological and clinical data from the initial Wuhan studies, and emphasize several features of SARS-CoV-2, which differentiate it from SARS-CoV and Middle East respiratory syndrome coronavirus (MERS-CoV), such as high variability of disease presentation. We systematize the current clinical trials that have been rapidly initiated after the outbreak of COVID-19 pandemic. Whereas the trials on SARS-CoV-2 genome-based specific vaccines and therapeutic antibodies are currently being tested, this solution is more long-term, as they require thorough testing of their safety. On the other hand, the repurposing of the existing therapeutic agents previously designed for other virus infections and pathologies happens to be the only practical approach as a rapid response measure to the emergent pandemic, as most of these agents have already been tested for their safety. These agents can be divided into two broad categories, those that can directly target the virus replication cycle, and those based on immunotherapy approaches either aimed to boost innate antiviral immune responses or alleviate damage induced by dysregulated inflammatory responses. The initial clinical studies revealed the promising therapeutic potential of several of such drugs, including favipiravir, a broad-spectrum antiviral drug that interferes with the viral replication, and hydroxychloroquine, the repurposed antimalarial drug that interferes with the virus endosomal entry pathway. We speculate that the current pandemic emergency will be a trigger for more systematic drug repurposing design approaches based on big data analysis.

Bioinformatic prediction of potential T cell epitopes for SARS-Cov-2

“…Many researches are now underway to develop effective interventions for controlling and preventing the COVID-19 pandemic, including therapeutic drugs such as inhibitors of the RNA-dependent RNA polymerase or the viral protease, and blockers of virus-cell membrane fusion as well as vaccines, and large scale clinical trials have just begun [6,7]. For the vaccine design against SARS-CoV-2 and the evaluation of immunogenicity of candidate vaccines, it is important to predict epitopes of SARS-CoV-2 and detect their immune responses to SARS-CoV-2.…”

In Silico Trial to test COVID-19 candidate vaccines: a case study with UISS platform

“…Currently, there are at least 42 vaccine candidates around the world under development and evaluation at different stages against COVID-19 [14], also accordingly from what reported by WHO through its continuously undergoing landscapes documents concerning the COVID-19 candidate vaccines. These promising vaccine candidates deal with several vaccine technologies based on recombinant protein subunits [15], nucleic acids [16], non-replicating and replicating viral vectors [17], [18], protein constructs [19], virus-like particles [20], liveattenuated virus strains [21], inactivated virus [14], or human monoclonal antibodies (mAbs) [22].…”

Targeting ACE2-RBD interaction as a platform for COVID19 therapeutics: Development and drug repurposing screen of an AlphaLISA proximity assay

“…Given that no approved therapeutics for treating any coronaviruses existed at the time SARS-CoV-2 emerged (late 2019), early attention has focused on drug repurposing opportunities 1,2 . Drug repurposing is an attractive approach to treating SARS-CoV-2, as active FDA-approved drugs or unapproved drug candidates previously shown to be safe in human clinical trials can be fast-tracked to the clinic.…”