Scoping insight on antiviral drugs against COVID-19

Abstract

Background COVID-19 is an ongoing viral pandemic produced by SARS-CoV-2. In light of in vitro efficacy, several medications were repurposed for its management. During clinical use, many of these medications produced inconsistent results or had varying limitations. Objective The purpose of this literature review is to explain the variable efficacy or limitations of Lopinavir/Ritonavir, Remdesivir, Hydroxychloroquine, and Favipiravir in clinical settings. Method A study of the literature on the pharmacodynamics (PD), pharmacokinetics (PK), safety profile, and clinical trials through academic databases using relevant search terms. Results & Discussion The efficacy of an antiviral drug against COVID-19 is associated with its ability to achieve therapeutic concentration in the lung and intestinal tissues. This efficacy depends on the PK properties, particularly protein binding, volume of distribution, and half-life. The PK and PD of the model drugs need to be integrated to predict their limitations. Conclusion Current antiviral drugs have varying pharmacological constraints that may associate with limited efficacy, especially in severe COVID-19 patients, or safety concerns. Disclaimer What was mentioned in this paper is a scientific view and information relating to general principles which should not be construed as specific instructions to change or criticize any protocols. But rather an academic discussion to push further research and development of these drugs for better achievements.

Repositioned Natural Compounds and Nanoformulations: A Promising Combination to Counteract Cell Damage and Inflammation in Respiratory Viral Infections

“…Considering the high level of global health emergency, this approach was widely used during the COVID-19 pandemic given the need for valid therapeutic treatment. Indeed, the first medical approaches were based on clinical analysis of the activity of antivirals such as Remdesivir, Favipiravir and antimalarial drugs such as Chloroquine and Hydroxychloroquine, to control pathological events caused by COVID-19 [ 64 , 65 , 66 , 67 ]. This approach was also widely used to control the immune-mediated hyperinflammatory response, typical of several viral infections, including SARS-CoV-2 infection.…”

Evaluation of the Polysaccharide “Immeran” Activity in Syrian hamsters’ Model of SARS-CoV-2

“…There are several antiviral drugs [ 10 ], including favipiravir, which are approved for the treatment of viral diseases [ 11 ] and have been studied in clinical trials in COVID-19 patients [ 12 , 13 , 14 , 15 ]. However, there are some works questioning the efficacy of standard approved drugs in COVID-19 patients—favipiravir [ 14 , 16 ], remdesivir [ 17 ], interferon therapy [ 18 ], hydroxychloroquine [ 19 ] and lopinavir [ 20 ]; at the same time, adverse side effects of these drugs in COVID-19 patients were exhibited to a full extent.…”

Assessment of toxicological effects of favipiravir (T‐705) on the lung tissue of rats: An experimental study

“…[ 15 ] However, some studies suggested that up to 50% of favipiravir blood distribution is detected in lung tissue. [ 16,17 ] Additionally, in a review, it was shown that favipiravir causes side effects in hepatic, gastrointestinal, hematologic, metabolic, and respiratory systems. [ 18 ]…”

“…[15] However, some studies suggested that up to 50% of favipiravir blood distribution is detected in lung tissue. [16,17] Additionally, in a review, it was shown that favipiravir causes side effects in hepatic, gastrointestinal, hematologic, metabolic, and respiratory systems. [18] Currently, favipiravir which is frequently used in patients with COVID-19 and many other viral diseases are known to cause side effects in various organ and systems.…”