Abstract
The SARS-CoV-2 outbreak originally appeared in China in December 2019 and became a global pandemic in March 2020. This infectious disease has directly affected public health and the world economy. Several palliative therapeutic treatments and prophylaxis strategies have been used to control the progress of this viral infection, including pre-(PrEP) and post-exposure prophylaxis. On the other hand, research groups around the world are still studying novel drug prophylaxis and treatment using repurposing approaches, as well as vaccination options, which are in different pre-clinical and clinical testing phases. This systematic review evaluated 1,228 articles from the PubMed and Scopus indexing databases, following the Kitchenham bibliographic searching protocol, with the aim to list drug candidates, potentially approved to be used as new options for SARS-CoV-2 prophylaxis clinical trials and medical protocols. In searching protocol, we used the following keywords: “Covid-19 or SARS-CoV-2” or “Coronavirus or 2019 nCoV,” “prophylaxis,” “prophylactic,” “pre-exposure,” “COVID-19 or SARS-CoV-2 Chemoprophylaxis,” “repurposed,” “strategies,” “clinical,” “trials,” “anti-SARS-CoV-2,” “anti-covid-19,” “Antiviral,” “Therapy prevention in vitro,” in cells “and” human testing. After all protocol steps, we selected 60 articles that included: 15 studies with clinical data, 22 studies that used in vitro experiments, seven studies using animal models, and 18 studies performed with in silico experiments. Additionally, we included more 22 compounds between FDA approved drugs and drug-like like molecules, which were tested in large-scale screenings, as well as those repurposed approved drugs with new mechanism of actions. The drugs selected in this review can assist clinical studies and medical guidelines on the rational repurposing of known antiviral drugs for COVID-19 prophylaxis.
Highlights
The SARS-CoV-2 outbreak originally appeared in China in December 2019 and became a global pandemic in March 2020 (Xie et al, 2020)
We present a systematic analysis of the main antiviral drug agents for many diseases, which can be proposed as new prophylaxis in clinical trials against SARS-CoV-2 infection and other therapeutic interventions
The analysis of articles’ contents indicated that: 15 studies were done with clinical data; 22 studies used in vitro approaches against pathogenic virus strains responsible for airway and pulmonary infections, such as influenza and SARS-CoV-2; seven studies used animal models; and 18 studies performed in silico experiments against viral targets
Summary
The SARS-CoV-2 outbreak originally appeared in China in December 2019 and became a global pandemic in March 2020 (Xie et al, 2020). There are two main categories of prophylaxis (I) preexposure prophylaxis (PrEP), which considers that treated individuals that had no contact with the pathogen (II) postexposure prophylaxis (PEP), which includes individuals that may have been infected (e.g. contact with patients) but have not exhibited the disease symptoms (Zhang et al, 2020). These two models of prophylactic studies have been extensively used in endemic viral pathologies with high transmissivity, such as HIV (Krakower et al, 2015). PrEP and PEP have proven to be extremely effective strategies in viral transmission control for patients inside certain risk groups, such as those with comorbidities, and health professionals directly exposed to the risk of acquiring and transmitting Covid-19 (Rockstroh et al, 2020)
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