Current pharmacological treatments for SARS-COV-2: A narrative review

Eur J Pharmacol. 2020 Sep 5:882:173328. doi: 10.1016/j.ejphar.2020.173328. Epub 2020 Jun 27.

Abstract

The novel coronavirus, later identified as SARS-CoV-2, originating from Wuhan in China in November 2019, quickly spread around the world becoming a pandemic. Despite the knowledge of previous coronaviruses, such as those responsible for the SARS and MERS-CoV epidemic, there is no drug or prophylaxis treatment to this day. The rapid succession of scientific findings on SARS-CoV-2 provides a significant number of potential drug targets. Nevertheless, at the same time, the high quantity of clinical data, generated by a large number of rapidly infected people, require accurate tests regarding effective medical treatments. Several in vitro and in vivo studies were rapidly initiated after the outbreak of the pandemic COVID-19. Initial clinical studies revealed the promising potential of remdesivir that demonstrated a powerful and specific in vitro antiviral activity for COVID-19. Promising effects appear to be attributable to hydroxychloroquine. Remdesivir and hydroxychloroquine are being tested in ongoing randomized trials. In contrast, oseltamivir was not effective and corticosteroids are not currently recommended. However, few data from ongoing clinical trials are identifying low molecular weight heparins, innate immune system stimulating agents, and inflammatory modulating agents as potential effective agents. The authors assume that the current pandemic will determine the need for a systematic approach based on big data analysis for identifying effective drugs to defeat SARS-Cov-2. This work is aimed to be a general reference point and to provide an overview as comprehensive as possible regarding the main clinical trials in progress at the moment.

Keywords: COVID-19; Clinical trials; Coronavirus; Pharmacological treatments; SARS-CoV-2; Therapies.

Publication types

  • Review

MeSH terms

  • Adenosine Monophosphate / analogs & derivatives
  • Adenosine Monophosphate / pharmacology
  • Adenosine Monophosphate / therapeutic use
  • Adjuvants, Immunologic / pharmacology*
  • Adjuvants, Immunologic / therapeutic use
  • Alanine / analogs & derivatives
  • Alanine / pharmacology
  • Alanine / therapeutic use
  • Antiviral Agents / pharmacology*
  • Antiviral Agents / therapeutic use
  • Betacoronavirus / drug effects*
  • Betacoronavirus / immunology
  • Betacoronavirus / pathogenicity
  • COVID-19
  • COVID-19 Drug Treatment
  • Clinical Trials as Topic
  • Coronavirus Infections / drug therapy*
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / virology
  • Glucocorticoids / pharmacology
  • Glucocorticoids / therapeutic use
  • Heparin, Low-Molecular-Weight / pharmacology
  • Heparin, Low-Molecular-Weight / therapeutic use
  • Humans
  • Hydroxychloroquine / pharmacology
  • Hydroxychloroquine / therapeutic use
  • Immunity, Innate / drug effects
  • Inflammation Mediators / pharmacology*
  • Inflammation Mediators / therapeutic use
  • Oseltamivir / pharmacology
  • Oseltamivir / therapeutic use
  • Pandemics
  • Pneumonia, Viral / drug therapy*
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / virology
  • SARS-CoV-2
  • Treatment Outcome

Substances

  • Adjuvants, Immunologic
  • Antiviral Agents
  • Glucocorticoids
  • Heparin, Low-Molecular-Weight
  • Inflammation Mediators
  • Oseltamivir
  • remdesivir
  • Adenosine Monophosphate
  • Hydroxychloroquine
  • Alanine