Abstract
A new strain of coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) responsible for the coronavirus disease 2019 (COVID-19) pandemic was first detected in the city of Wuhan in Hubei province, China in late December 2019. To date, more than 1 million deaths and nearly 57 million confirmed cases have been recorded across 220 countries due to COVID-19, which is the greatest threat to global public health in our time. Although SARS-CoV-2 is genetically similar to other coronaviruses, i.e., SARS and Middle East respiratory syndrome coronavirus (MERS-CoV), no confirmed therapeutics are yet available against COVID-19, and governments, scientists, and pharmaceutical companies worldwide are working together in search for effective drugs and vaccines. Repurposing of relevant therapies, developing vaccines, and using bioinformatics to identify potential drug targets are strongly in focus to combat COVID-19. This review deals with the pathogenesis of COVID-19 and its clinical symptoms in humans including the most recent updates on candidate drugs and vaccines. Potential drugs (remdesivir, hydroxychloroquine, azithromycin, dexamethasone) and vaccines [mRNA-1273; measles, mumps and rubella (MMR), bacille Calmette-Guérin (BCG)] in human clinical trials are discussed with their composition, dosage, mode of action, and possible release dates according to the trial register of US National Library of Medicines (clinicaltrials.gov), European Union (clinicaltrialsregister.eu), and Chinese Clinical Trial Registry (chictr.org.cn) website. Moreover, recent reports on in silico approaches like molecular docking, molecular dynamics simulations, network-based identification, and homology modeling are included, toward repurposing strategies for the use of already approved drugs against newly emerged pathogens. Limitations of effectiveness, side effects, and safety issues of each approach are also highlighted. This review should be useful for the researchers working to find out an effective strategy for defeating SARS-CoV-2.
Highlights
The novel coronavirus disease, COVID-19, was first identified in the city of Wuhan, China at the end of December 2019
A successful vaccine would be the ultimate prophylaxis to defeat COVID-19, but no such vaccine is yet available for humans, and past experience suggests that the development of a new vaccine could take 4–28 years
The New York Times estimated that a COVID-19 vaccine could be available in 2036, after completion of academic research, a series of preclinical and clinical trials, building factories, manufacturing, approval, and distribution (Thomson, 2020)
Summary
The novel coronavirus disease, COVID-19, was first identified in the city of Wuhan, China at the end of December 2019. As of 22 November 2020, around 4,000 studies on COVID-19 were registered in the US National Library of Medicine (NLM) website, of which many are ongoing in different hospitals around the world. These studies mostly focused on vaccines trials, drugs development, and in silico therapeutics for the patients. A number of in silico studies revealed that peptide-like and small molecules including drugs (cobicistat, ritonavir, lopinavir, and darunavir) are potentially effective CoV-2 protease inhibitors (Pant et al, 2020; Shah et al, 2020). A revisit to the discoveries of COVID-19 therapeutics is intended to provide updated knowledge about ongoing trials and future scope for investigation, of interest to researchers, and policymakers
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