Repurposing current therapeutics for treating COVID‐19: A vital role of prescription records data mining

Abstract

Since its outbreak in late 2019, the SARS‐Cov‐2 pandemic already infected over 3.7 million people and claimed more than 250,000 lives globally. At least 1 year may take for an approved vaccine to be in place, and meanwhile millions more could be infected, some with fatal outcome. Over thousand clinical trials with COVID‐19 patients are already listed in http://ClinicalTrials.com, some of them for assessing the utility of therapeutics approved for other conditions. However, clinical trials take many months, and are typically done with small cohorts. A much faster and by far more efficient method for rapidly identifying approved therapeutics that can be repurposed for treating COVID‐19 patients is data mining their past and current electronic health and prescription records for identifying drugs that may protect infected individuals from severe COVID‐19 symptoms. Examples are discussed for applying health and prescription records for assessing the potential repurposing (repositioning) of angiotensin receptor blockers, estradiol, or antiandrogens for reducing COVID‐19 morbidity and fatalities. Data mining of prescription records of COVID‐19 patients will not cancel the need for conducting controlled clinical trials, but could substantially assist in trial design, drug choice, inclusion and exclusion criteria, and prioritization. This approach requires a strong commitment of health provides for open collaboration with the biomedical research community, as health provides are typically the sole owners of retrospective drug prescription records.

Candesartan could ameliorate the COVID-19 cytokine storm

“…Immunoglobulin was reported to be effective in severely ill COVID-19 patients [ 153 ]. The use of beta-estradiol and simvastatin is currently being evaluated in interventional clinical trials [ 154 ]. Not surprisingly, many proinflammatory cytokines (TNF, IL1B, IL6, IL13), PRRs such as TLR4 and TLR7, and inflammation-inducing drugs such as lipopolysaccharide were found to positively correlate with COVID-19 upregulated genes.…”

Liver injury, SARS‐COV‐2 infection and COVID‐19: What physicians should really know?

“…13 Furthermore, the epithelium of bile ducts plays an important role in liver regeneration and in the regulation of immune response. 14 In cholangiocytes the virus replicates actively and decreases claudin-1 expression, determining tight junction disruption between cholangiocytes and in turn the impairment of bile acid transport and function. Some studies have seen that ductal cells are usually susceptible to infections, with a consequent impairment of barrier function and the transport of bile acids.…”

Drug Repurposing for COVID-19 using Graph Neural Network with Genetic, Mechanistic, and Epidemiological Validation

“…As of today (August 27, 2020), there have been over 24 million COVID-19 cases worldwide, but no vaccine or highly effective antiviral treatment for COVID-19 patients is available yet (1). While many millions more will likely be infected, some pessimistic estimation is that it may take at least one year for an approved effective vaccine to be in place (2). Lack of vaccine or antiviral drugs with clinical efficacy substantiates the need to expand research efforts in the prevention and/or treatment for COVID-19 (3,4).…”

“…Examples include a network proximity study in protein-protein interaction (PPI) networks (13)(14)(15), in silico protein docking (16), and sequencing analysis (17). Another family of studies has utilized retrospective analysis of clinical data, such as electronic health records (EHRs) (2). These studies have assessed the potential efficacy of drugs including angiotensin receptor blockers, estradiol, or antiandrogens (2,18).…”

“…Another family of studies has utilized retrospective analysis of clinical data, such as electronic health records (EHRs) (2). These studies have assessed the potential efficacy of drugs including angiotensin receptor blockers, estradiol, or antiandrogens (2,18). Although the network pharmacology and the retrospective clinical data analysis provide complementary insight into potential drugs (19), few studies have investigated by integrating these complementary perspectives, particularly in COVID-19.…”