Modalities and Mechanisms of Treatment for Coronavirus Disease 2019

Abstract

Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is spreading rapidly throughout the world. Although COVID-19 has a relatively low case severity rate compared to SARS and Middle East Respiratory syndrome it is a major public concern because of its rapid spread and devastating impact on the global economy. Scientists and clinicians are urgently trying to identify drugs to combat the virus with hundreds of clinical trials underway. Current treatments could be divided into two major part: anti-viral agents and host system modulatory agents. On one hand, anti-viral agents focus on virus infection process. Umifenovir blocks virus recognizing host and entry. Remdesivir inhibits virus replication. Chloroquine and hydroxychloroquine involve preventing the whole infection process, including virus transcription and release. On the other hand, host system modulatory agents are associated with regulating the imbalanced inflammatory reaction and biased immune system. Corticosteroid is believed to be commonly used for repressing hyper-inflammation, which is one of the major pathologic mechanisms of COVID-19. Convalescent plasma and neutralizing antibodies provide essential elements for host immune system and create passive immunization. Thrombotic events are at high incidence in COVID-19 patients, thus anti-platelet and anti-coagulation are crucial, as well. Here, we summarized these current or reproposed agents to better understand the mechanisms of agents and give an update of present research situation.

Virtual Screening of Repurposed Drugs as Potential Spike Protein Inhibitors of Different SARS-CoV-2 Variants: Molecular Docking Study

“…Nelfinavir mesylate might bind inside the S protein with subsequent inhibition virus entry and spike mediated cell fusion [ 13 ]. Umifenovir, known as arbidol, is involved in the reduction of the replication of SARS-CoV-2 at both viral entry and post-entry stages [ 45 , 46 ]. Umifenovir alone did not improve the clinical outcome of COVID-19 patients [ 45 ].…”

“…Umifenovir, known as arbidol, is involved in the reduction of the replication of SARS-CoV-2 at both viral entry and post-entry stages [ 45 , 46 ]. Umifenovir alone did not improve the clinical outcome of COVID-19 patients [ 45 ]. Our finding that umifenovir efficiently binds to most of the current SARS-CoV-2 variants, except the delta and beta variants, agrees with the study that reported a positive RNA test of shorter duration with umifenovir treatment in comparison to the lopinavir/ritonavir treated group [ 47 ].…”

Original Hosts, Clinical Features, Transmission Routes, and Vaccine Development for Coronavirus Disease (COVID-19)

“…Recently, high rate of thromboembolism has also been defined as an important feature of patients with COVID-19 (75,76). Compared with mild patients, higher levels of plasma cytokines were observed among severe patients, suggesting an immunopathological process caused by a cytokine storm (77,78). Fortunately, most patients recovered enough to be discharged in 2 weeks.…”

Pharmacological treatment of COVID-19: an opinion paper

“…The first randomized, placebo-controlled, phase III clinical trial with remdesivir was published in 2020. It included 237 patients, with severe disease and O 2 Since the primary host immune response appears 10 to 14 days after infection, plasma should be collected from donors no earlier than the second or third week after SARS-CoV-2 infection [43].…”

“…Immunoglobulins and convalescent plasma (CP) is obtained from persons who have recovered from COVID-19. Since the primary host immune response appears 10 to 14 days after infection, plasma should be collected from donors no earlier than the second or third week after SARS-CoV-2 infection [ 43 ].…”