Repurposing Approved Drugs for Guiding COVID-19 Prophylaxis: A Systematic Review

Abstract

The SARS-CoV-2 outbreak originally appeared in China in December 2019 and became a global pandemic in March 2020. This infectious disease has directly affected public health and the world economy. Several palliative therapeutic treatments and prophylaxis strategies have been used to control the progress of this viral infection, including pre-(PrEP) and post-exposure prophylaxis. On the other hand, research groups around the world are still studying novel drug prophylaxis and treatment using repurposing approaches, as well as vaccination options, which are in different pre-clinical and clinical testing phases. This systematic review evaluated 1,228 articles from the PubMed and Scopus indexing databases, following the Kitchenham bibliographic searching protocol, with the aim to list drug candidates, potentially approved to be used as new options for SARS-CoV-2 prophylaxis clinical trials and medical protocols. In searching protocol, we used the following keywords: “Covid-19 or SARS-CoV-2” or “Coronavirus or 2019 nCoV,” “prophylaxis,” “prophylactic,” “pre-exposure,” “COVID-19 or SARS-CoV-2 Chemoprophylaxis,” “repurposed,” “strategies,” “clinical,” “trials,” “anti-SARS-CoV-2,” “anti-covid-19,” “Antiviral,” “Therapy prevention in vitro,” in cells “and” human testing. After all protocol steps, we selected 60 articles that included: 15 studies with clinical data, 22 studies that used in vitro experiments, seven studies using animal models, and 18 studies performed with in silico experiments. Additionally, we included more 22 compounds between FDA approved drugs and drug-like like molecules, which were tested in large-scale screenings, as well as those repurposed approved drugs with new mechanism of actions. The drugs selected in this review can assist clinical studies and medical guidelines on the rational repurposing of known antiviral drugs for COVID-19 prophylaxis.

Of bats and men: Immunomodulatory treatment options for COVID-19 guided by the immunopathology of SARS-CoV-2 infection

“…Effective treatments acting in a directly antiviral fashion can reduce viral replication and load. Such therapeutics should be efficacious in any COVID-19 stage, but with greater effect in stages 1 and 2 (152), in which virus-induced cellular injury and subsequent localized, mild to moderate inflammation are the dominant pathologies (Fig. 2).…”

Long-COVID and Post-COVID Health Complications: An Up-to-Date Review on Clinical Conditions and Their Possible Molecular Mechanisms

“…Since the start of the COVID-19 pandemic, an increasing number of studies have focused on rapid diagnosis, development, and redirection of new therapies. However, it was discovered that SARS-CoV-2 is more than just a respiratory syndrome [9][10][11]. High levels of endogenous chemical substances produced in response to the inflammation caused by this virus are capable of generating alterations and disturbances in target tissues.…”

Predicting COVID-19—Comorbidity Pathway Crosstalk-Based Targets and Drugs: Towards Personalized COVID-19 Management

“…Although several drugs have been tested for repurposing in COVID-19 therapy and several drugs are under clinical trials [ 20 , 21 , 22 ], none of these drugs have proven to be the gold standard to treat the disease. The treatment becomes more complex while considering the comorbid conditions due to the lack of comorbidity assessment, drug–drug interactions [ 23 ], and most importantly, lack of knowledge of the pathway crosstalk between COVID-19 and its comorbid conditions to understand the complexity in pathogenesis.…”