Possible therapeutic agents for COVID-19: a comprehensive review

Abstract

Introduction: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has emerged in China. There are no available vaccines or antiviral drugs for COVID-19 patients. Herein, we represented possible therapeutic agents that may stand as a potential therapy against COVID-19. Areas covered: We searched PubMed, Google Scholar, and clinicaltrials.gov for relevant papers. We showed some agents with potentially favorable efficacy, acceptable safety as well as good pharmacokinetic profiles. Several therapies are under assessment to evaluate their efficacy and safety for COVID-19. However, some drugs were withdrawn due to their side effects after demonstrating some clinical efficacy. Indeed, the most effective therapies could be organ function support, convalescent plasma, anticoagulants, and immune as well as antiviral therapies, especially anti-influenza drugs due to the similarities between respiratory viruses regarding viral entry, uncoating, and replication. We encourage giving more attention to favipiravir, remdesivir, and measles vaccine. Expert opinion: A combination, at least dual or even triple therapy, of the aforementioned efficacious and safe therapies is greatly recommended for COVID-19. Further, patients should have a routine assessment for their coagulation and bleeding profiles as well as their inflammatory and cytokine concentrations.

Intuition on virology, epidemiology, pathogenesis, and control of COVID-19

“…On the other side, researchers from China conducted a randomized controlled trial (RCT) to determine the efficacy of this drug on a group composed of 99 patients of COVID-19, but results showed that there was no significant clinical improvement. Moreover, Ortiz-Prado et al, (2020); Elhusseiny et al, (2020) listed the safety profile of this drug and confirmed that it showed many side effects including; rash, nausea, diarrhea and asthenia.…”

“…replication (Dhama et al, 2020). In addition, Elhusseiny et al, (2020) reported that a follow-up study of 53 COVID-19 patients who were treated with remdesivir showed that 68% of the patients were improved clinically, and 47% were successfully discharged. Another recent trial conducted by Grein et al, (2020) on treatment of 53 COVID-19 patients with remdesivir by applying this drug intravenously for 9 days (200 mg at day 1 and 100 mg daily for 9 days), showed clinical improvements in 68% of the patients.…”

“…Several recent studies of Ortiz-Prado et al, (2020); Jean and Hsueh, (2020); Elhusseiny et al, (2020) reported that to control SARS-CoV-2, antiviral drugs including; ribavirin, lopinavir, remdesivir, favipiravir, arbidol, oseltamivir, chloroquine, azithromycin, etc. are taken for COVID-19 therapy.…”

“…Regarding COVID-19, a high dose of ribavirin is found to limit viral infection, so this may be the potential drug for use that requires large-sized clinical trials. However, according to Elhusseiny et al, (2020), the use of this drug is associated with risk of hemolytic anemia and significant hemoglobin reduction, which may result in the fatigue, rash, leukopenia and teratogenicity.…”

“…With regard to COVID-19 patients, some reports showed that the use of this combined drug therapy revealed antiviral activity. Elhusseiny et al, (2020) stated that this drug significantly reduced the viral load in a Korean patient. Likewise, another report also showed significant antiviral activity in three Chinese patients (Elhusseiny et al, 2020).…”