Antiviral treatment of COVID-19

Abstract

IntroductionCurrently, there is not any specific effective antiviral treatment for COVID-19. Although most of the COVID-19 patients have mild or moderate course, up to 5-10% can have severe , potentially life threatening course, there is an urgent need for effective drugs [1]. Optimized supportive care remains the mainstay of therapy. As new data regarding clinical characteristics, treatment options, and outcomes for COVID-19 emerges approximately every hour, physicians who are in the care of patients should keep themselves up to date on this issue. There have been more than 300 clinical trials going on, and some of them will be published in the next couple of months. The WHO is launching "Solidarity" clinical trial for COVID-19 treatments to further evaluate remdesivir, hydroxychloroquine/chloroquine, and lopinavir-ritonavir with and without interferon beta 1 . Various other antiviral and immunomodulating agents are 1 World Health Organization (2020). "Solidarity" clinical trial for COVID-19 treatments [online]. Website https://www.who.int/ emergencies/diseases/novel-coronavirus-2019/global-research-on-novel-coronavirus-2019-ncov/solidarity-clinical-trial-for-covid-19treatments [accessed 12 April 2020]. 2 Bhimraj A, Morgan RL, Shumaker AH, Lavergne V, Baden5 L et al. Infectious DiseasesSociety of America Guidelines on the Treatment and Management of Patients with COVID-19 Infection [online]. Website https://www.idsociety.org/globalassets/idsa/ practice-guidelines/covid-19/treatment/idsa-covid-19-gl-tx-and-mgmt-4-11-20-1058-am-edt.pdf [accessed 12 April 2020].in various stages of evaluation for COVID-19. A registry of international clinical trials can be found on the WHO website and at ClinicalTrials.gov.At the moment, it is strongly recommended that patients be recruited into ongoing trials, which would provide much-needed evidence on the efficacy and safety of various therapies for COVID-19, given that we could not determine whether the benefits outweigh harms for most treatments [2] 2 .Unless used in the context of randomized clinical trials, antivirals will not be proved to be efficacious or safe for the treatment of COVID-19. In the 2014 Ebola outbreak, close to 30, 000 individuals developed Ebola viral disease, and numerous therapies were tested against this virus, including chloroquine, hydroxychloroquine, favipiravir, brincidofovir, monoclonal antibodies, antisense RNA, and convalescent plasma, among many others. With such a large number of therapeutic interventions given to affected Abstract: Currently, there is not any specific effective antiviral treatment for COVID-19. Although most of the COVID-19 patients have mild or moderate courses, up to 5%-10% can have severe, potentially life threatening course, there is an urgent need for effective drugs. Optimized supportive care remains the mainstay of therapy. There have been more than 300 clinical trials going on, various antiviral and immunomodulating agents are in various stages of evaluation for COVID-19 in those trials and some of them will be publish...

The effect of favipiravir on QTc interval in patients hospitalized with coronavirus disease 2019

“…Favipiravir is an antiviral agent that selectively and potently inhibits the RNA-dependent RNA polymerase of RNA viruses. [ 18 ] Favipiravir, which is used to counter RNA viruses, such as EVD and influenza, is a broad-spectrum drug and is used in COVID-19 treatment, having been approved for use in COVID-19 treatment in March 2020 in China [ 19 ]. Currently, favipiravir, widely used in many countries, has a safe profile, but concerns remain about its effects on the QTc interval.…”

High-throughput Screening and Experimental Identification of Potent Drugs Targeting SARS-CoV-2 Main Protease

“…To date, a number of old drugs have been clinically tested for potential e cacy against SARS-CoV-2, such as lopinavir/ritonavir, hydroxychloroquine, darunavir and cobicistat 20,21,24,25 . Although some of these molecules are effective in cellular models, clinical trials showed no signi cant improvement in symptoms and length of hospitalization 21,26 ; thus, the e cacy of these drugs remains controversial.…”

Quantum dots as a promising agent to combat COVID‐19

“…As a result, for the time being, antiviral therapy-based medications such as remdesivir, lopinavir-ritonavir, and favipiravir are used as prodrugs to inhibit the activity of the viral RNA polymerase. [12] Likewise, drugs such as chloroquine and its derivative hydroxychloroquine exhibit antiviral (against severe acute respiratory syndrome coronavirus [SARS-CoV] and human coronavirus OC43 [HCoV-OC43]) and prophylactic activities, respectively. [13][14][15] Preliminary research findings suggest that chloroquine and its derivative hydroxychloroquine can be used to treat COVID-19, as it has the ability to interfere with viral-cell effusion.…”