Update on therapeutic approaches and emerging therapies for SARS-CoV-2 virus

Abstract

The global pandemic of coronavirus disease 2019 (COVID-19), caused by novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in over 7,273,958 cases with almost over 413,372 deaths worldwide as per the WHO situational report 143 on COVID-19. There are no known treatment regimens with proven efficacy and vaccines thus far, posing an unprecedented challenge to identify effective drugs and vaccines for prevention and treatment. The urgency for its prevention and cure has resulted in an increased number of proposed treatment options. The high rate and volume of emerging clinical trials on therapies for COVID-19 need to be compared and evaluated to provide scientific evidence for effective medical options. Other emerging non-conventional drug discovery techniques such as bioinformatics and cheminformatics, structure-based drug design, network-based methods for prediction of drug-target interactions, artificial intelligence (AI) and machine learning (ML) and phage technique could provide alternative routes to discovering potent Anti-SARS-CoV2 drugs. While drugs are being repurposed and discovered for COVID-19, novel drug delivery systems will be paramount for efficient delivery and avoidance of possible drug resistance. This review describes the proposed drug targets for therapy, and outcomes of clinical trials that have been reported. It also identifies the adopted treatment modalities that are showing promise, and those that have failed as drug candidates. It further highlights various emerging therapies and future strategies for the treatment of COVID-19 and delivery of Anti-SARS-CoV2 drugs.

Keywords: COVID-19; Clinical trials; Drug targets; Re-purposing; SARS-CoV2; Vaccines.

Graphical abstract

Fig. 1

SARS-CoV-2 replication circle involves cellular entry which is via fusion and endocytosis, after entry translation occurs as the virus uses host cells enzyme it creates its DNA. This is followed proteolysis then translation to back to RNA after that packaging and viral release occurs. The circles.

Fig. 2

Network-based methodology combining pharmacology-based network medicine platform to quantify the interplay between the virus–host interactome and drug targets in the human protein-protein interactions network. a Human coronavirus (HCoV) associated host protein sourced from literature and pooled to generate a protein subnetwork. b Network proximity between drug targets and HCoV-associated proteins that were calculated to screen for candidate repurposability. c, d Gene set utilized to validate the network-based prediction. e Prioritization of top candidates for drug combinations using network based. Reproduced with permission from (Zhu et al., 2020).

Fig. 3

Mechanisms of nano-encapsulated therapeutic molecules against SARS-CoV-2 virus. Different drugs can be encapsulated in nanodrug delivery system with ability to specifically target the virus or its infection sites. Enzymes specific to the lungs, conditions peculiar to COVID-19 such as pH and receptors can be employed to specifically increase the drug concentration at the SARS-CoV-2 infection sites.