The current COVID-19 pandemic has elicited extensive repurposing efforts (both small
and large scale) to rapidly identify COVID-19 treatments among approved drugs. Herein,
we provide a literature review of large-scale SARS-CoV-2 antiviral drug repurposing
efforts and highlight a marked lack of consistent potency reporting. This variability
indicates the importance of standardizing best practices—including the use of
relevant cell lines, viral isolates, and validated screening protocols. We further
surveyed available biochemical and virtual screening studies against SARS-CoV-2 targets
(Spike, ACE2, RdRp, PL
pro
, and M
pro
) and discuss repurposing
candidates exhibiting consistent activity across diverse, triaging assays and predictive
models. Moreover, we examine repurposed drugs and their efficacy against COVID-19 and
the outcomes of representative repurposed drugs in clinical trials. Finally, we propose
a drug repurposing pipeline to encourage the implementation of standard methods to
fast-track the discovery of candidates and to ensure reproducible results.