Insights into antiviral mechanisms of remdesivir, lopinavir/ritonavir and chloroquine/hydroxychloroquine affecting the new SARS-CoV-2

Abstract

Graphical abstract

Systematic Review on the Therapeutic Options for COVID-19: Clinical Evidence of Drug Efficacy and Implications

“…Consequently, an LPV/r combination may be useful in treating mild, moderate, and severe COVID-19 infection. 119 In a triple therapy study, LPV/r was potentially promising by suppressing the viral load, while methylprednisolone reduced the incidence of pneumonia and the need for ICU admission. 120 Ye et al (2020), in an early study in China involving 47 patients, revealed that lopinavir/ritonavir lowered body temperature and restored normal physiological functions more effectively than seen in a control group.…”

“…As a result, remdesivir may have a place in patient treatment with mild to moderate COVID-19 disease. 119 , 134 Conversely, the initial studies with remdesivir failed to demonstrate clinical benefit over placebo; however, there were concerns that the investigations were underpowered. 32 , 135 Spinner et al (2020), in a study involving 596 COVID-19 patients, found those patients randomized to a 10-day course of remdesivir did not show a statistically significant improvement in their health status versus standard care randomized.…”

Interactions of Potential Anti-COVID-19 Compounds with Multispecific ABC and OATP Drug Transporters

“…SARS-CoV-2 virus replication requires the cleavage of viral polyproteins, and the proteases 3CLpro and PLpro are responsible for this cleavage. In vitro, lopinavir and ritonavir were found to inhibit 3CLpro, and thus reduce SARS-CoV-2 replication [ 19 ]. However, these drugs are poorly selective and high concentrations are required to achieve in vivo inhibition [ 20 ].…”

A review of potential suggested drugs for coronavirus disease (COVID-19) treatment

“…These protease inhibitors mimic the normal peptide linkage and bind to the substrate-binding pockets of viral enzymes such as papain-like cysteine proteinase (PLpro) and 3C-like proteinase (3CLpro). By inhibiting the enzyme activity, drugs prevent the proteolysis of Gag polyprotein precursors, which causes the formation of immature, non-infectious viral particles ( Uzunova et al, 2020 ).…”