Abstract
On 11 March 2020, the coronavirus disease (COVID-19) was defined by the World Health Organization as a pandemic. Severe acute respiratory syndrome-2 (SARS-CoV-2) is the newly evolving human coronavirus infection that causes COVID-19, and it first appeared in Wuhan, China in December 2019 and spread rapidly all over the world. COVID-19 is being increasingly investigated through virology, epidemiology, and clinical management strategies. There is currently no established consensus on the standard of care in the pharmacological treatment of COVID-19 patients. However, certain medications suggested for other diseases have been shown to be potentially effective for treating this infection, though there has yet to be clear evidence. Therapies include new agents that are currently tested in several clinical trials, in addition to other medications that have been repurposed as antiviral and immune-modulating therapies. Previous high-morbidity human coronavirus epidemics such as the 2003 SARS-CoV and the 2012 Middle East respiratory syndrome coronavirus (MERS-CoV) prompted the identification of compounds that could theoretically be active against the emerging coronavirus SARS-CoV-2. Moreover, advances in molecular biology techniques and computational analysis have allowed for the better recognition of the virus structure and the quicker screening of chemical libraries to suggest potential therapies. This review aims to summarize rationalized pharmacotherapy considerations in COVID-19 patients in order to serve as a tool for health care professionals at the forefront of clinical care during this pandemic. All the reviewed therapies require either additional drug development or randomized large-scale clinical trials to be justified for clinical use.
Highlights
The pandemic of the coronavirus disease (COVID-19) has quickly spread to affect almost all countries and territories around the world
This review aims to summarize rationalized pharmacotherapy considerations in COVID-19 patients in order to serve as a tool for health care professionals at the forefront of clinical care during this pandemic
In a study that included 199 adult patients admitted to the hospital with severe COVID-19, lopinavir/ritonavir treatment did not show any benefits compared with the conventional care regarding the time to clinical improvement, viral load, or mortality [26]
Summary
The pandemic of the coronavirus disease (COVID-19) has quickly spread to affect almost all countries and territories around the world. This review covers the key medications suggested as potential agents under investigation in registered clinical trials for the treatment of COVID-19. They are either repurposed antiviral, other anti-infective, or immunomodulatory agents, in addition to drugs that act on host cell receptors. The broad strategies for COVID-19 treatment include the targeting of key enzymes of SARS-CoV-2, interfering with the viral cycle inside the host cell by using repurposed antiviral drugs previously tested for other coronaviruses like SARS-CoV and MERS-CoV, as well as other RNA virus infections, e.g., HIV and HCV. This review covers key medications proposed for COVID-19 that have been registered in various clinical trials (https://clinicaltrials.gov/), including the Chinese clinical trial database (http://www.chictr. org.cn/index.aspx)
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