Discovering drugs to treat coronavirus disease 2019 (COVID-19)

Original Article: Dong L, Hu S, Gao J. Discovering drugs to treat coronavirus disease 2019 (COVID-19). Drug Discov Ther. 2020;14(1):58-60.

Author of summary: Maria Clara Liuzzi; Reviewer: Stefania Principe

Original Article Published on February 29th, 2020

The article summarises the current findings on the preclinical and clinical usage of different drugs in the treatment of COVID-19 in China, their main therapeutic implications and the wide on going research.

The effort of scientists is focused now to find antivirals specific to the virus. Several drugs are currently undergoing clinical studies to test their efficacy and safety in the treatment of coronavirus disease 2019 (COVID-19) in China.

Antivirals such as interferon α (IFN-α), lopinavir/ritonavir, chloroquine phosphate, ribavirin, and arbidol have been included in the Guidelines for the Prevention, Diagnosis, and Treatment of pneumonia induced by COVID-19 disease by the National Health Commission (NHC) in China. The article refers to the latest edition of the document dated 18 February 2020. Guidelines include administration routes and dosages for each drug, with all administrations to be for no longer than ten days.

IFN- α is a broad-spectrum antiviral usually used for hepatitis; lopinavir/ritonavir is a medication combination to treat individuals affected by HIV; ribavirin is a broad-spectrum antiviral; chloroquine is widely used as anti-malarial; arbidol can be used to treat influenza virus. All these antivirals have been selected to be used in national clinical trials according to their good ranges of activity and effectiveness showed against SARS-CoV in vitro, or according to their coadjuvant positive effect against acute respiratory symptoms that often source from SARS-like infections.

Besides from those antivirals included in the Chinese guidelines, the paper also mentions other drugs currently under revision as potential alternative treatments against SARS-CoV; the first drug mentioned is Favipiravir, a new type of RNA polymerase inhibitor recently been approved for the treatment of novel influenza in China, thought to be potentially effective also against SARS-CoV, since it’s a RNA virus.

Another drug mentioned is Remdesivir, broad-spectrum antiviral that has been showing promising effects in different settings, and that is now in a phase III multi-centred national clinical trial due to conclude at the end of April.

The paper also mentions drugs as darunavir (HIV-protease inhibitor), imatinib (BCR-ABL kinase inhibitor) and type II transmembrane serine protease (TMSPSS2) inhibitors, that due to their mechanisms of action could interfere with the viral fusion and entrance in the host cell at different levels, and therefore be a potential alternative in the treatment of COVID-19.

Furthermore, a joint research team in Shanghai performed enzymatic screens that allowed for the selection of thirty potentially active agents, and the discovery of potentially active ingredients in some traditional herbal medicines.

In conclusion, even though there is still no confirmed treatment for COVID-19, there is definitely a large range of on going preclinical and clinical research in China at the moment focused on assessing the efficacy and most importantly the safety of various potential future drugs.

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