Abstract
The coronavirus disease of 2019 (COVID-19) has caused an unprecedented global crisis. The etiological agent is a new virus called the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). As of October, 2020 there have been 45.4 million confirmed cases with a mortality rate of 2.6% globally. With the lack of a vaccine and effective treatments, the race is on to find a cure for the virus infection using specific antivirals. The viral RNA-dependent RNA polymerase, proteases, spike protein-host angiotensin-converting enzyme 2 binding and fusion have presented as attractive targets for pan-coronavirus and broad spectrum direct-acting antivirals (DAAs). This review presents a perspective on current re-purposing treatments and future DAAs.
Highlights
A new disease, coronavirus disease of 2019 (COVID-19), caused by the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) was announced in December, 2019 in Wuhan, China (Huang et al, 2020)
Very recently the largest clinical RECOVERY trial comparing 2104 randomized, controlled patients to 4321 patients receiving usual care in the United Kingdom determined that a 10-day course of low to moderate dose (6 mg/day) of dexamethasone was able to reduce mortality rate in patients who were on ventilators by one-third and in patients who required oxygen therapy by one-fifth (Horby et al, 2020)
Since the trial dexamethasone has immediately been authorized by the United Kingdom government to treat COVID-19 patients (Ledford, 2020)
Summary
A new disease, coronavirus disease of 2019 (COVID-19), caused by the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) was announced in December, 2019 in Wuhan, China (Huang et al, 2020). Ill patients manifest as acute respiratory distress syndrome (ARDS) and require oxygen therapy and mechanical ventilator intervention (Huang et al, 2020). Dexamethasone is a steroid and is effective in calming the overactive immune response in critically ill ARDS patients. This review will give a perspective on current re-purposing and future DAAs in the treatment of COVID-19 patients. COVID-19 Direct-Acting Antivirals a new virus is rapid re-purposing of existing drugs with known safety, dosages and pharmacokinetic properties. This will be followed by structure-guided development of specific antivirals. The etiological agent of COVID-19 is SARS-CoV-2 (Zhu N.et al, 2020) It is a large positive-sense, single-stranded RNA virus (Figure 1). The holy grail is an antiviral that is pan-coronavirus and broad-spectrum for the current and future pandemics
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