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COVID-19 Treatment:Current and Emerging Options


Affiliations
1 Aristo Pharmaceuticals Private Limited, Mumbai, India
     

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Coronavirus disease 2019 (COVID-19) which is caused by the Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) has posed a clinical threat to the global population. Its resemblance to SARS-CoV along with several other bat coronaviruses have been established through genome sequencing- related studies. The disease spreads by human-to-human transmission via droplets or direct contact and presents flu-like symptoms. It can have poor prognosis in high-risk individuals having co-morbid conditions. Though currently, no proven effective therapies for SARS-CoV-2 exist, many therapeutic agents are being repurposed to treat patients with COVID-19. The key aspect determining the prognosis of COVID-19 patients is the early accurate diagnosis followed by the management of acute respiratory failure and hemodynamic instability in moderate-severe cases. COVID-19 presents an unparalleled chal-lenge to identify potential therapeutic agents for prophylaxis and treatment. There is an explicit and urgent need to explore all the possible prophylactic and therapeutic strategies to curb the spread of SARS-CoV-2. A large number of clinical trials have been launched to investigate potential therapies for COVID-19 and to provide the clinicians ac-curate evidence regarding effective medical treatments for this infection. The current review closely examines the drugs that are being explored and also those drugs which have a potential for consideration. Though the therapeutic options have not undergone extensive pre-clinical and clinical testing, each has a known merit and identified mecha-nism against viral infection. The review is based on currently available information and as new evidence emerges, reappraisal of therapies is anticipated.

Keywords

COVID-19, Management, SARS-CoV-2, Potential Therapies, Evidence.
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  • Katulanda P, Dissanayake H A, Ranathunga I, Ratnasamy V et al. Prevention and management of COVID-19 among patients with diabetes: an appraisal of the literature. Diabetologia (2020). https://doi.org/10.1007/s00125-020-05164-x

  • Ky B, Mann DL. COVID-19 Clinical Trials A Primer for the Cardiovascular and Cardio-Oncology Communities. 2020; 5(5): 501 – 17

  • Lundstrom K. Coronavirus Pandemic—Therapy and Vaccines. Biomedicines 2020; 8(109): 1-25.

  • Sanders JM, Monogue LM, Jodlowski TZ, Cutrell JB. Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19) A Review. JAMA. 2020; 323(18):1824-1836.

  • Chatterjee P, Anand T, Singh KJ, Rasaily R et al. Healthcare workers & SARS-CoV-2 infection in India: A case-control in-vestigation in the time of COVID-19. Indian J Med Res[Epub ahead of print] [cited 2020 Jun 5].

  • Das S, Bhowmick S, Tiwari S, Sen S. An Updated Systematic Review of the Therapeutic Role of Hydroxychloroquine in Coronavirus Disease-19 (COVID-19). Clin Drug Investig (2020). https://doi.org/10.1007/s40261-020-00927-1

  • Choudhary R, Sharma AK. Potential use of hydroxychloroquine, ivermectin and azithromycin drugs in fighting COVID-19: trends, scope and relevance. New Microbes New Infect. 2020; 35: 100684.

  • Pizzorno A, Padey B, Julien T, Trouillet-Assant S. Characterization and treatment of SARS-CoV-2 in nasal and bronchial human airway epithelia. https://doi.org/10.1101/2020.03.31.017889.

  • Beigel JH, Tomashek K.M, Dodd L.E, Mehta AK. Remdesivir for the Treatment of Covid-19 — Preliminary Report. N Engl J Med DOI: 10.1056/NEJMoa2007764.

  • Wang Y, Zhang D, Du G, Du R. Remdesivir in adults with se-vere COVID-19: a randomized, double-blind, placebo-controlled, multicenter trial. Lancet 2020; 395: 1569–78.

  • Wu Renyi, Wang L, Kuo HCD, Shannar A. et al. An Update on Current Therapeutic Drugs Treating COVID-19. Curr Pharmacol Rep. 2020May 11; 1-15.

  • Chen C, Huang J, Cheng Z, Wu J. Favipiravir versus Arbidol for COVID-19: A Randomized Clinical Trial. 2020; DOI: 10.1101/2020.03.17.20037432.

  • Cai Q, Yang M, Liu D, Chen J. Experimental Treatment with Favipiravir for COVID-19: An Open-Label Control Study. Engineering, https://doi.org/10.1016/j.eng.2020.03.007.

  • Simsek Yavuz, Unal S. Antiviral treatment of COVID-19. Turk J Med Sci. 2020; 50(3): 611–619.

  • Retrieved from https://www.who.int/blueprint/priority-diseases/key action/Table_of_therapeutics_Appendix_17022020.pdf? ua=1.

  • Caly L, Druce JD, Catton MG, Jans DA et al. The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro. Antiviral Res. 2020Jun; 178: 104787.

  • Retrieved from https://www.trialsitenews.com/ivermec-tin-usage-accelerates-while-the-need-for-data-is-real-how-about-an-ivermectin-registry/ on 31 May 2020.

  • Sharun K, Dhama K, Patel K, Pathak M. Ivermectin, a new candidate therapeutic against SARS-CoV-2/COVID-19. Ann Clin Microbiol Antimicrob (2020) 19:23.

  • Dorward J, Gbinigie K. Lopinavir/ritonavir: A rapid review of effectiveness in COVID-19. https://www.cebm.net/cov-id-19/lopinavir-ritonavir-a-rapid-review-of-the-evidence-for-effectiveness-in-treating-covid/

  • Li L, Li R, Wu Z, Yang X. Therapeutic strategies for critically ill patients with COVID-19. Ann. Intensive Care (2020) 10:45.

  • Cao B, Wang Y, Wen D, Liu W et al. A Trial of Lopinavir– Ritonavir in Adults Hospitalized with Severe Covid-19. N Engl J Med 2020; 382:1787-1799.

  • Dalerba P, Levin B, Thompson JL. A Trial of Lopinavir– Ritonavir in Covid-19. N Engl J Med382; 21.

  • Khalili JS, Zhu H, Mak NSA, Yan Y. Novel coronavirus treatment with ribavirin: Groundwork for an evaluation con-cerning COVID-19. J Med Virol. 2020; 1–7.

  • Ríos DG, VA, Agudelo López, Ramírez-Malule H. Repurposing antivirals as potential treatments for SARS-CoV-2: From SARS to COVID-19. Journal of Applied Pharmaceutical Science Vol.2020; 10(05):001-009.

  • Hung IFN, Lung KC, Tso EYK, Liu R et al. Triple combination of interferon beta-1b, lopinavirBritonavir, nd ribavirin in the treatment of patients admitted to hospital with COVID-19: an open-label, randomised, phase 2 trials.Lancet 2020; 395: 1695–704.

  • Li H, Liu SM, Yu XH, Tang SL et al. Coronavirus disease 2019 (COVID-19): current status and future perspectives. Int J Antimicrob Agents. 2020May; 55(5): 105951.

  • Cunningham AC, Goh HP, Koh D. Treatment of COVID-19: old tricks for new challenges. Critical Care (2020);24(91):1-2.

  • Mair-Jenkins J, Saavedra-Campos M, Baillie JK, Cleary P. The Effectiveness of Convalescent Plasma and Hyperimmune Immunoglobulin for the Treatment of Severe Acute Respiratory Infections of Viral Etiology: A Systematic Review and Exploratory Meta-analysis. J Infect Dis 2015Jan 1; 211(1):80-90.

  • Zeng QL, Yu ZJ, Gou JJ, Li GM. Effect of Convalescent Plasma Therapy on Viral Shedding and Survival in COVID-19 Patients. J Infect Dis. 2020:1-16.

  • Luo P, Liu Yi, Qiu L, Liu X. Tocilizumab treatment in COVID-19: A single center experience. Tocilizumab treat-ment in COVID-19: A single center experience.J Med Virol. 2020; 1–5.

  • Le TT, Andreadakis, Z, Kumar A, Roman GR. The COVID-19 vaccine development landscape. Nature Reviews Drug Discovery. 2020; 19: 305-306.

  • Retrieved from http://www.pharmabiz.com/NewsDetails.aspx?aid=126573&sid=1 on June 5, 2020.

  • Derbyshire E, Delange J. bmjnph 2020;0:1–6. doi:10.1136/bmjnph-2020-000071

  • R. Derwand, M. Scholz. Does zinc supplementation enhance the clinical efficacy of chloroquine/hydroxychloroquine to win today’s battle against COVID-19? Medical Hypotheses 142 (2020)109815.


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  • COVID-19 Treatment:Current and Emerging Options

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Authors

Manish Maladkar
Aristo Pharmaceuticals Private Limited, Mumbai, India
Chitra Tekchandani
Aristo Pharmaceuticals Private Limited, Mumbai, India
Akshata Karchodi
Aristo Pharmaceuticals Private Limited, Mumbai, India

Abstract


Coronavirus disease 2019 (COVID-19) which is caused by the Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) has posed a clinical threat to the global population. Its resemblance to SARS-CoV along with several other bat coronaviruses have been established through genome sequencing- related studies. The disease spreads by human-to-human transmission via droplets or direct contact and presents flu-like symptoms. It can have poor prognosis in high-risk individuals having co-morbid conditions. Though currently, no proven effective therapies for SARS-CoV-2 exist, many therapeutic agents are being repurposed to treat patients with COVID-19. The key aspect determining the prognosis of COVID-19 patients is the early accurate diagnosis followed by the management of acute respiratory failure and hemodynamic instability in moderate-severe cases. COVID-19 presents an unparalleled chal-lenge to identify potential therapeutic agents for prophylaxis and treatment. There is an explicit and urgent need to explore all the possible prophylactic and therapeutic strategies to curb the spread of SARS-CoV-2. A large number of clinical trials have been launched to investigate potential therapies for COVID-19 and to provide the clinicians ac-curate evidence regarding effective medical treatments for this infection. The current review closely examines the drugs that are being explored and also those drugs which have a potential for consideration. Though the therapeutic options have not undergone extensive pre-clinical and clinical testing, each has a known merit and identified mecha-nism against viral infection. The review is based on currently available information and as new evidence emerges, reappraisal of therapies is anticipated.

Keywords


COVID-19, Management, SARS-CoV-2, Potential Therapies, Evidence.

References