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Abstract
The need for proven disease-specific treatments for the novel pandemic coronavirus SARS-CoV-2 necessitates a worldwide search for therapeutic options. Since the SARS-CoV-2 virus shares extensive homology with SARS-CoV and MERS-CoV, effective therapies for SARS-CoV and MERS-CoV may also have therapeutic potential for the current COVID-19 outbreak. To identify therapeutics that might be repositioned for treatment of the SARS-CoV-2 disease COVID-19, we strategically reviewed the literature to identify existing therapeutics with evidence of efficacy for the treatment of the three coronaviruses that cause severe respiratory illness (SARS-CoV, MERS-CoV, and SARS-CoV-2). Mechanistic and in vitro analyses suggest multiple promising therapeutic options with potential for repurposing to treat patients with COVID-19. Therapeutics with particularly high potential efficacy for repurposing include camostat mesylate, remdesivir, favipiravir, tocilizumab, baricitinib, convalescent plasma, and humanized monoclonal antibodies. Camostat mesylate has shown therapeutic potential, likely by preventing viral entry into epithelial cells. In early research, the targeted antivirals remdesivir and favipiravir appear to benefit patients by decreasing viral replication; clinical trials suggest that remdesivir speeds recovery from COVID-19. Tocilizumab and baricitinib appear to improve mortality by preventing a severe cytokine storm. Convalescent plasma and humanized monoclonal antibodies offer passive immunity and decreased recovery time. This review highlights potential therapeutic options that may be repurposed to treat COVID-19 and suggests opportunities for further research.
Highlights
The new pandemic coronavirus disease 2019 (COVID-19) is caused by the novel Severe AcuteRespiratory Syndrome coronavirus 2 (SARS-CoV-2), which belongs to the Coronaviridae family [1].The Coronaviridae family is a cohort of viruses with single-stranded, positive-sense RNA genomes that typically cause both respiratory and enteric diseases [2]
The novel pandemic COVID-19 is an emergent threat to global health [102]
COVID-19 is caused by a novel coronavirus that is structurally similar to the SARS-CoV virus that causes Severe
Summary
The new pandemic coronavirus disease 2019 (COVID-19) is caused by the novel Severe AcuteRespiratory Syndrome coronavirus 2 (SARS-CoV-2), which belongs to the Coronaviridae family [1].The Coronaviridae family is a cohort of viruses with single-stranded, positive-sense RNA genomes that typically cause both respiratory and enteric diseases [2]. The new pandemic coronavirus disease 2019 (COVID-19) is caused by the novel Severe Acute. Respiratory Syndrome coronavirus 2 (SARS-CoV-2), which belongs to the Coronaviridae family [1]. The Coronaviridae family is a cohort of viruses with single-stranded, positive-sense RNA genomes that typically cause both respiratory and enteric diseases [2]. Respiratory Syndrome coronavirus (SARS-CoV), Middle East Respiratory Syndrome coronavirus (MERS-CoV), and SARS-CoV-2 can cause severe respiratory illnesses, known as SARS, MERS, and COVID-19, respectively. The current pandemic COVID-19 is a primarily respiratory disease with a spectrum of severity ranging from mild upper respiratory illness to acute respiratory distress syndrome, pneumonia, multi-organ failure, and death [3]. The three coronaviruses SARS-CoV, MERS-CoV, and SARS-CoV-2 all belong to the betacoronavirus genus [3]. Sequence analysis of the SARS-CoV-2 genome shows that it is 82% identical to that of SARS-CoV [1], whereas MERS-CoV shares approximately 50% genomic sequence identity with
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