Abstract
The COVID-19 pandemic, caused by SARS-CoV-2, is considered as the major health emergency in a century. Clinically, most patients have mild to moderate symptoms. Nevertheless, elderly or with comorbidities patients may develop one of the most severe complication of COVID-19, that is, the cytokine storm syndrome. Currently, there are no approved treatments for SARS-CoV-2. Meanwhile, therapeutic strategies are based on previous experience with other viruses. This article will review the different therapeutic agents proposed for the treatment of COVID-19 based on the blocking and inhibition of the viral life cycle of SARS-CoV-2, and for the treatment of cytokine storm syndrome. A narrative review was performed by searching in the PubMed database. Among the main therapeutic target against SARS-CoV-2 are the major structural protein Spike and viral enzymes 3-chymotrypsin-like protease, viral papain-like protease, and RNA-dependent RNA polymerase. Remdesivir, an adenosine analogue antiviral that inhibits RNA-dependent RNA polymerase, is considered the most promising drug in the treatment of COVID-19. Nonetheless, its efficacy has not yet been determined. In the cytokine storm syndrome, the tissue injury caused by the virus may induce the exaggerated production of pro-inflammatory cytokines such as interleukin-6. Tocilizumab, a monoclonal antibody that blocks interleukin-6 receptors, and corticosteroids such as methylprednisolone may be therapeutic options in treating the severity of the syndrome.
Highlights
Since December 2019, an unknow pneumonia associated with a novel human coronaviruses, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), named by the International Committee on Taxonomy of Viruses (ICTV) and named as coronavirus disease 2019 (COVID-19) by World Health Organization (WHO), emerged in Wuhan, China (1)(2)(3)
A narrative review was performed by searching in the PubMed database with the search algorithm: (((Therapeutics AND Viral Life Cycle OR Cytokine Storm Syndrome OR angiotensin-converting enzyme 2 (ACE2) OR Spike Protein OR 3-chymotrypsin-like protease OR papain-like protease OR RNA-dependent RNA polymerase) OR Immunotherapy) AND (COVID-19 OR SARS-CoV-2))
Similar to SARS-CoV, SARS-CoV-2 utilizes host receptor, angiotensin-converting enzyme 2 (ACE2), for its attachment and entry (33) ACE2 is a zinc metalloprotease that contributes to regulation of blood pressure by converting angiotensin II to angiotensin (1-7) (26)(33)(34)
Summary
Since December 2019, an unknow pneumonia associated with a novel human coronaviruses, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), named by the International Committee on Taxonomy of Viruses (ICTV) and named as coronavirus disease 2019 (COVID-19) by World Health Organization (WHO), emerged in Wuhan, China (1)(2)(3). The COVID-19 pandemic is sorely testing health care systems around the world and is considered as the major health emergency in a century (6). Based on phylogenetic and genomic relationships, SARS-CoV-2 belongs to genera Betacoronavirus (9). The external envelope is composed of major structural proteins (Spike (S), Membrane (M) and Envelope (E) proteins) and accessory proteins (11). The S protein is important for attachment to the host cells, the M and E proteins are necessary for virus assembly, the N protein is involved in the transcription and replication of the viral RNA and packaging of the genome into new virions (11)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
