Novel coronavirus treatment with ribavirin: Groundwork for an evaluation concerning COVID‐19

Abstract

Confronting the challenge of the outbreak of COVID-19 should sharpen our focus on global drug access as a key issue in antiviral therapy testing. The testing and adoption of effective therapies for novel coronaviruses are hampered by the challenge of conducting controlled studies during a state of emergency. The access to direct antiviral drugs, such as ribavirin, that have an existing inventory and reliable supply chain may be a priority consideration for therapies developed for the 2019-nCoV infection outbreaks and any strain variants that may emerge. On the basis of the direct antiviral activity of ribavirin against 2019-nCoV in vitro and evidence for potency enhancement strategies developed during the prior SARS and MERS outbreaks, ribavirin may significantly impact our ability to end the lingering outbreaks in China and slow outbreaks in other countries. The apparent COVID-19 pandemic provides an opportunity to follow dosage guidelines for treatment with ribavirin, test new therapeutic concepts, and conduct controlled testing to apply the scientific rigor required to address the controversy around this mainstay of antiviral therapy.

The effectiveness of antiviral treatment in severe COVID-19 patients in Wuhan: a retrospective cohort study

“…The effectiveness of antiviral treatment for COVID-19 is still controversial. Many researchers consider that ribavirin, remdesivir, lopinavir, emetine, and homoharringtonine have shown e cacy to inhibit SARS-CoV-2 or other coronavirus replication in vitro and combinational therapy may help to reduce the effective concentration of SARS-CoV-2 [13][14][15][16]. The molecular docking study has shown that the effectiveness of ribavirin, remdesivir, sofosbuvir, galidesivir and tenofovir as potent drugs for treating SARS-CoV-2 infection [17].…”

Analysis of clinical characteristics, nucleic acid detection and prognosis of 72 cases of common type Corona Virus Disease 2019(COVID-19) pneumonia in Hubei Province,China

“…But whether oseltamivir can improve the prognosis of patients needs further study to con rm. Previous studies have shown the potential effect of ribavirin on nCoV [13]. Among the possible studies that should be completed are drug combinations that use the widely available abidol, interferon.…”

Enantiomers of Chloroquine and Hydroxychloroquine Exhibit Different Activities Against SARS-CoV-2in vitro, EvidencingS-Hydroxychloroquine as a Potentially Superior Drug for COVID-19

“…[8][9][10] Many of these have been evaluated against SARS-CoV-2 in vitro. These include some medications commonly used for decades, such as chloroquine, [11][12][13] arbidol, 14 ribavirin, [15][16][17] lopinavir, etc., [18][19][20] The list also contains some drugs in development, for instance, remdesivir, 11,17 a previously studied drug candidate for treating Ebola infection. [21][22] Among the most notable and also controversial repurposed drugs are chloroquine (CQ) and hydroxychloroquine (HCQ) as shown in Figure 1A, with several initial promising results especially when combined with azithromycin or zinc supplement being reported, [23][24][25][26][27][28][29][30][31] only to be followed by contradicting reports [32][33][34][35][36][37] on lack of efficacy and presence of severe side effects, especially among the higher dosed patients.…”