A Review on Current Repurposing Drugs for the Treatment of COVID-19: Reality and Challenges

Abstract

The coronavirus disease 2019 (COVID-19) caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a global pandemic with a high growth rate of confirmed cases. Therefore, therapeutic options are desperately urgent to fight with this damning virus. As it may take years to develop a specific therapy of COVID-19, it is urgent to emphasize the repurposing of drugs used for other conditions. This study reviewed the most common drugs for COVID-19 based on available online literature representing the latest in vitro clinical trial database, rational of use, adverse effects, potential toxicities, and US National Institute of Health (NIH) recommendation to use for COVID-19. Based on the preliminary data from clinical trials and considering the NIH and FDA recommendation, remdesivir and convalescent blood products are the most promising potential for COVID-19 treatment. The use of chloroquine, hydroxychloroquine, favipiravir, ivermectin, and colchicine might also be effective. However, furthermore, in vivo investigations are needed in detail individually and in combination for possible benefits in humans. Besides, tocilizumab might be deemed as adjunctive therapy for patients with cytokine release syndrome. However, lopinavir-ritonavir, anakinra, and sarilumab had not proven their clinical efficacy. Eventually, sarilumab has been withdrawn from sponsored clinical trials based on the preliminary data. Baricitinib and ruxolitinib have the additive immunosuppressive effect. Consequently, all of these drugs are being evaluated with further studies. In addition, drug-drug interaction and safety concerns must be taken into account before the administration of the recommended drugs.

Prevention and treatment of COVID-19: Focus on interferons, chloroquine/hydroxychloroquine, azithromycin, and vaccine

“…Moreover, CQ inhibits the viral RNA and DNA polymerase, virion assembly, and viral shedding ( Fig. 1 ) [ 16 ]. CQ can interact with the LV/RTV in COVID-19 patients, and cause the prolongation of the QT interval [ 131 ].…”

“…In addition, there are specially approved treatment strategies for urgent use during the COVID-19 pandemic despite the lack of substantial data. These emergency treatment strategies include the use of remdesivir and convalescent plasma in the USA and favipiravir in China [ [14] , [15] , [16] ]. Along with trials of different treatment options, several vaccine candidates are under evaluation.…”

Albendazole Reduces Serum Levels of Inflammatory Cytokines: Potential Strategy for the Management of Cytokine Storm

“…Despite ongoing intensive research on prevention, control and management of COVID-19 pandemic, no known specific and effective drugs or vaccines have been developed to manage or prevent COVID-19 [1][2][3]. Therefore, many drugs have been evaluated in its management and the search continues.…”

“…Therefore, many drugs have been evaluated in its management and the search continues. Hosseinet al, [1] reported that based on the preliminary data from clinical trials and considering the National Institute of Health (NIH) and Food and Drug Administration (FDA) recommendation, remdesivir and convalescent blood products are the most promising potential for COVID-19 treatment. The group [1] added that the uses of chloroquine, hydroxychloroquine, favipiravir, ivermectin, and colchicine might also be effective.…”

“…Hosseinet al, [1] reported that based on the preliminary data from clinical trials and considering the National Institute of Health (NIH) and Food and Drug Administration (FDA) recommendation, remdesivir and convalescent blood products are the most promising potential for COVID-19 treatment. The group [1] added that the uses of chloroquine, hydroxychloroquine, favipiravir, ivermectin, and colchicine might also be effective. Tocilizumab was deemed as adjunctive therapy for patients with cytokine release syndrome while baricitinib and ruxolitinib were reported to have additive immunosuppressive effect [1].…”