Abstract
The Covid-19 pandemic is highly contagious and has spread rapidly across the globe. To date there have been no specific treatment options available for this life-threatening disease. During this medical emergency, target-based drug repositioning/repurposing with a continuous monitoring and recording of results is an effective method for the treatment and drug discovery. This review summarizes the recent findings on COVID-19, its genomic organization, molecular evolution through phylogenetic analysis and has recapitulated the drug targets by analyzing the viral molecular machinery as drug targets and repurposing of most frequently used drugs worldwide and their therapeutic applications in COVID-19. Data from solidarity trials have shown that the treatment with Chloroquine, hydroxychloroquine and lopinavir-ritonavir had no effect in reducing the mortality rate and also had adverse side effects. Remdesivir, Favipiravir and Ribavirin might be a safer therapeutic option for COVID-19. Recent clinical trial has revealed that dexamethasone and convalescent plasma treatment can reduce mortality in patients with severe forms of COVID-19.
Highlights
Background informationSevere Acute Respiratory Syndrome coronavirus 2 (SARSCoV-2), previously known as 2019 novel coronavirus (2019nCoV), is a novel species of Coronaviridae family, which causes COVID-19, the ongoing pandemic outbreak across the globe
SARS-corona viruses (CoV)-2 was first reported in Wuhan, Hubei Province, China in December 2019 as a novel pathogen causing pneumonia (Zhu et al 2020)
Studies on the SARS-CoV-2 in Vero E6 cells against Lopinovir exhibited anti-viral activity and the estimated EC50 at 26.63 μM (Choy et al 2020), whereas the recent randomized, open-label, controlled trial including patients of COVID-19 received Lopinavir along with Ritonavir (LPV/r) (400 mg/100 mg) twice daily for 14 days compared with the standard care revealed no significant difference in viral clearance and mortality rate (Cao et al 2020)
Summary
Severe Acute Respiratory Syndrome coronavirus 2 (SARSCoV-2), previously known as 2019 novel coronavirus (2019nCoV), is a novel species of Coronaviridae family, which causes COVID-19, the ongoing pandemic outbreak across the globe. Studies on the SARS-CoV-2 in Vero E6 cells against Lopinovir exhibited anti-viral activity and the estimated EC50 at 26.63 μM (Choy et al 2020), whereas the recent randomized, open-label, controlled trial including patients of COVID-19 received LPV/r (400 mg/100 mg) twice daily for 14 days compared with the standard care revealed no significant difference in viral clearance and mortality rate (Cao et al 2020). Dexamethasone is a corticosteroid with anti-inflammatory and immunosuppressant properties and has been used in the treatment of certain cancer, inflammatory disorders, severe influenza, SARS-CoV, MERS-CoV, and community acquired pneumonia This drug was given to COVID-19 patients in the United Kingdom’s national clinical trial—Randomized Evaluation of COVID-19 Therapy (RECOVERY (https://www.recoverytrial.net/)), and demonstrated positive preliminary results. Since there is no specific antiviral or vaccine for the critically ill patients, there is an urgent need for an alternative treatment strategy like the usage of convalescent plasma (Russell et al 2020; Shang et al 2020)
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