Potential Treatment Options for COVID-19: A Comprehensive Review of Global Pharmacological Development Efforts

Abstract

Coronavirus disease-2019 (COVID-19), first reported in China during December of 2019, is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Infection later spread very rapidly around the globe with over 8,708,008 cases reported, including more than 461,715 deaths reported across at least 216 countries by June 20, 2020. It was declared as a global pandemic by the World Health Organization (WHO) on March 11, 2020. With the rapidly increasing number of positive cases and deaths, there is a dire need for effective treatment. An urgent unmet need led to the planning and opening of multiple drug development trials for treatment and vaccine development. In this article, we have compiled comprehensive data on many candidate drugs such as remdesivir, favipiravir, ribavirin, umifenovir, arbidol, lopinavir, ritonavir, baricitinib, hydroxychloroquine, nitazoxanide, azithromycin, baloxavir, oseltamivir, losartan, and tocilizumab. We have tabulated available data on various clinical trials testing various aspects of COVID-19 therapeutics.

Treatment Modalities of the Covid-19 Pandemic Through Repurposed Drugs and Status of Vaccines

“…Because of the whole genome sequenced and protein structure designing connected information, scientists have been able to fig. out possible drugs for the treatment of COVID-19 [44].…”

Current and Future Direct-Acting Antivirals Against COVID-19

“…The organization and 3D structure of the catalytic center XDD (SDD in coronaviruses) are well conserved in RdRps from coronaviruses and across the RNA virus family, making it a prime target for the development of pan-coronavirus and broad-spectrum antivirals ( Gao et al, 2020 ). That explains why a number of approved and investigational RdRp inhibitors are able to rapidly enter into COVID-19 clinical trials ( Neupane et al, 2020 ).…”

“…It has been shown to be ineffective in vitro against SARS-CoV-2 because SARS-CoV-2 encodes its own capping enzyme ( Choy et al, 2020 ; Wang et al, 2020d ). Nevertheless, Baloxavir has entered into a few clinical trials for COVID-19 ( Neupane et al, 2020 ; Zhang Q. et al, 2020 ).…”

COVID-19: the epidemiology and treatment

“…Glucocorticoids interact with cytoplasmic receptors and thereby alter gene transcription and consequent production of inflammatory mediators (Neupane et al, 2020). As they are potent anti-inflammatory agents, corticosteroids are commonly given to patients suffering from MERS or SARS to reduce disease-related inflammation and alveolar damage (Arabi et al, 2017).…”

“…Instead, it is generally administered in combination with lopinavir-ritonavir or interferons, resulting in enhanced efficacy and reduced infection duration (Hung et al, 2020). However, ribavirin is a potential teratogen and can cause leukopenia, haemolytic anaemia, gout, fatigue and skin reactions, making it suboptimal as a treatment for patients with COVID-19 (Neupane et al, 2020).…”