An update on emerging therapeutics to combat COVID‐19

Abstract

Background The COVID‐19 pandemic has demanded effective therapeutic protocol from researchers and clinicians across the world. Currently, a large amount of primary data have been generated from several preclinical studies. At least 300 clinical trials are underway for drug repurposing against COVID‐19; the clinician needs objective evidence‐based medication to treat COVID‐19. Observations Single‐stranded RNA viral genome of SARS‐CoV‐2 encodes structural proteins (spike protein), non‐structural enzymatic proteins (RNA‐dependent RNA polymerase, helicase, papain‐like protease, 3‐chymotrypsin‐like protease) and other accessory proteins. These four enzymatic proteins on spike protein are rate‐limiting steps in viral replications and, therefore, an attractive target for drug development against SARS‐CoV‐2. In silico and in vitro studies have identified various potential epitomes as candidate sequences for vaccine development. These studies have also revealed potential targets for drug development and drug repurposing against COVID‐19. Clinical trials utilizing antiviral drugs and other drugs have given inconclusive results regarding their clinical efficacy and side effects. The need for angiotensin‐converting enzyme (ACE‐2) inhibitors/angiotensin receptor blockers and corticosteroids has been recommended. Western countries have adopted telemedicine as an alternative to prevent transmission of infection in the population. Currently, no proven, evidence‐based therapeutic regimen exists for COVID‐19. Conclusion The COVID‐19 pandemic has put tremendous pressure on researchers to evaluate and approve drugs effective against the disease. Well‐controlled randomized trials should assess medicines that are not marketed with substantial evidence of safety and efficacy and more emphasis on time tested approaches for drug evaluation.

Home therapy of COVID‐19 at the earliest may greatly prevent hospitalization

“…The recent contribution by Naveed Nazir Shah and coworkers on the emerging therapeutics to combat COVID‐19 is a noteworthy synopsis of the developing strategy in fighting the SARS‐CoV2 pandemic, but these weapons are ordinarily adopted in a hospitalization context. 1 Treating patients undergoing the initial symptomatology of SARS‐CoV2 infection with the proper therapy protocol to prevent further hospitalization is the challenge.…”

“…Emerging pharmaceuticals are strategic to address the pandemic with encouraging results, 1 yet, in the meantime, current better availability of NSAIDs prompts physicians and practitioners to recommend primarily and more frequently these pharmaceuticals, with respect to affordable novelties. This consideration has put spotlight on the urgency to reach a commonly shared protocol rather than referring to one's own empiricism and medical practice.…”

ACEI or not to ACEI: Review on using ACEI and ARBs on COVID-19 patients: Systemic review

“…The spike (S) protein of SARS-CoV2 has two subunits; S1 and S2[6, 25, 27,28,30]. Entry of covid virus depends on subunit S1 binding to the cellular receptor, angiotensin-converting enzyme 2(ACE2), on the host cell.…”

Clinical Characterization and Outcomes of Patients with Hypercreatinemia Affected by COVID-19

“…A pneumonic disease outbreak caused by a novel beta-coronavirus, named “severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), occurred in Wuhan, China [ 1 , 2 , 3 ]. The disease caused by the virus is known as the Corona Virus Infectious Disease 2019 (COVID-19) and represents a source of concern for the treatment of patients with associated co-morbidities.…”