Pipeline Pharmacological Therapies in Clinical Trial for COVID-19 Pandemic: a Recent Update

Abstract

The emergence of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), responsible for causing coronavirus disease 2019 (COVID-19), marked the third time in the twenty-first century when a new, highly pathogenic human coronavirus outbreak has led to an epidemic. The COVID-19 epidemic has emerged in late December 2019 in Wuhan city of China and spread rapidly to other parts of the world. This quick spread of SARS-CoV-2 infection to many states across the globe affecting many people has led WHO to declare it a pandemic on March 12, 2020. As of July 4, 2020, more than 523,011 people lost their lives worldwide because of this deadly SARS-CoV-2. The current situation becomes more frightening as no FDA-approved drugs or vaccines are available to treat or prevent SARS-CoV-2 infection. The current therapeutic options for COVID-19 are limited only to supportive measures and non-specific interventions. So, the need of the hour is to search for SARS-CoV-2-specific antiviral treatments and to develop vaccines for SARS-CoV-2. Also, it is equally important to maintain our immunity, and natural products and Ayurvedic medicines are indispensable in this regard. In this review, we discuss recent updates regarding various therapeutic approaches to combat COVID-19 pandemic and enlist the major pipeline drugs and traditional medicines that are under trial for COVID-19. Also, possible mechanisms involved in viral pathogenesis are discussed, which further allow us to understand various drug targets and helps in discovering novel therapeutic approaches for COVID-19. Altogether, the information provided in this review will work as an intellectual groundwork and provides an insight into the ongoing development of various therapeutic agents.

Phytopharmaceuticals mediated Furin and TMPRSS2 receptor blocking: can it be a potential therapeutic option for Covid-19?

“… Phase 3 Kumari et al, 2020 Gum Arabic powder Immunomodulator and anti-inflammatory agent for potential use for covid-19 treatment. Phase 2 Kumari et al, 2020 Açaí Palm Berry extract For Potent inhibition of Nod-like receptor family, pyrin-containing 3 (NLRP3) inflammasome owing to attenuate the covid-19 syndrome Phase 2 Kumari et al, 2020 Traditional Chinese medicines (various herbal products are included in this category) For Immunomodulatory and anti-inflammatory mechanisms, decrease the level of cytokines such as TNF-α, IL-1β, IL-6, IL-8, and IL-10, to inhibit lung inflammation or acute lung injury Phase 3 Kumari et al, 2020 …”

Can Adenosine Fight COVID-19 Acute Respiratory Distress Syndrome?

“…Several therapies, already in use, have been adopted to combat COVID-19. Basically, they can be grouped into two large groups: antiviral therapy and immunotherapy [ 41 ]. First, glucocorticoids are administered in the more critical or early stages of the cytokine storm to prevent organ damage.…”

<p>COVID-19 Clinical Trials Registered Worldwide for Drug Intervention: An Overview and Characteristic Analysis</p>

“…Kumari et al described some of the most promising current drugs in a review of the updated pipeline for pharmacological therapies. 27 Some new directions include immunomodulators and biologics, traditional Chinese medicines and natural products and herbal medicines. The immunomodulators and biologics mainly consist of convalescent plasma, antibody-based therapy, cell-based therapy (NK cells and mesenchymal stem cells) and other therapies.…”

“…The immunomodulators and biologics mainly consist of convalescent plasma, antibody-based therapy, cell-based therapy (NK cells and mesenchymal stem cells) and other therapies. 27 Mesenchymal stem cells, a type of plasma immunotherapy, have shown good results in the treatment of COVID-19 patients. 28 In patients with severe COVID-19, excessive inflammatory cytokine storms and high oxidative stress are mutually promotive and aggravate the deterioration of the disease.…”

“…remain in the design of clinical trials: the overall trial design (random and sufficient efficacy, 47 the inclusion of sex as a variable 48 ), dose optimization, the lack of clear treatment timing window and the selection of appropriate outcome indicators. 27 For clinical trials on COVID-19 vaccines, Ayoub suggests that multiple doses of Bacillus Calmette-Guérin (BCG) vaccine should be considered a breakthrough in vaccine discovery and could lead to safer results. 49 For parallel implementations of the same intervention trial, Mathioudakis et al suggest that in terms of methodology, a meta-analysis of the interim data should be analyzed and its key results evaluated by the organization to shorten the time from identification as an effective drug to clinical application.…”