Promising drug repurposing approach targeted for cytokine storm implicated in SARS-CoV-2 complications

Abstract

A global threat has emerged in 2019 due to the rapid spread of Coronavirus disease (COVID-19). As of January 2021, the number of cases worldwide reached 103 million cases and 2.22 million deaths which were confirmed as the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). This global pandemic galvanized the scientific community to study the causative virus (SARS-CoV2) pathogenesis, transmission, and clinical symptoms. Remarkably, the most common complication associated with this disease is the cytokine storm which is responsible for COVID-19 mortality. Thus, targeting the cytokine storm with new medications is needed to hamper COVID-19 complications where the most prominent strategy for the treatment is drug repurposing. Through this strategy, several steps are skipped especially those required for testing drug safety and thus may help in reducing the dissemination of this pandemic. Accordingly, the aim of this review is to outline the pathogenesis, clinical features, and immune complications of SARS-CoV2 in addition to suggesting several repurposed drugs with their plausible mechanism of action for possible management of severe COVID-19 cases.

The effect of reparixin on survival in patients at high risk for in-hospital mortality: a meta-analysis of randomized trials

“…The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), made it necessary to repurpose existing drugs ( 1 ). Since an amplified inflammatory response leading to an uncontrolled cytokine release can be a consequence of SARS-CoV-2 infection, several anti-inflammatory drugs (glucocorticoids, non-steroidal anti-inflammatory drugs, interleukin antagonists, and kinase inhibitors) are being evaluated to be repositioned in COVID-19 ( 2 ).…”

Qingfei Paidu Decoction Inhibits LPS-induced Acute Lung Injury by Targeting the Complement Pathway

“…The direct inhibition of the massive release of cytokines from hyperactivated immune cells serve as a therapeutic strategy for ALI and SARS-CoV-2 infection. 35 To date, traditional Chinese medicine, including QFPD, has been widely used for the treatment of patients with COVID-19. 36 Compared to modern medicines, herbbased TCMs have exhibited several merits, including pronounced curative effects, fewer side effects, and lower costs.…”

The Effect of Rivaroxaban on CYP4F2 and Transcription Factors’ Activity in HUVECs

“…Rivaroxaban shows a pleiotropic effect. Recent research data suggest that FXa possesses a function in the process of coagulation; additionally, it may have a proinflammatory effect [14]. It was assumed that the inhibition of FXa with rivaroxaban may induce antiinflammatory responses and protect the vascular endothelium from inflammation.…”

“…A recent study showed that treatment with rivaroxaban is associated with a reduction in a key inflammation and coagulation biomarkers, resulting in decreased levels of D-dimer, the thrombin-antithrombin III complex (TAT), high-sensitivity C-reactive protein (hs-CRP) and high-sensitivity interleukin-6 (hs-IL-6) [15]. Due to its anti-inflammatory effect, rivaroxaban may also have a potential pleiotropic role in patients infected with SARS-CoV-2 [14].…”