Pharmacological treatments of COVID-19

Abstract

The viral infection due to the new coronavirus or coronavirus disease 2019 (COVID-19), which was reported for the first time in December 2019, was named by the World Health Organization (WHO) as Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV2), because of the very similar genome and also its related symptoms to SARS-CoV1. The ongoing COVID-19 pandemic with significant mortality, morbidity, and socioeconomic impact is considered by the WHO as a global public health emergency. Since there is no specific treatment available for SARS-CoV2 infection, and or COVID-19, several clinical and sub-clinical studies are currently undertaken to find a gold-standard therapeutic regimen with high efficacy and low side effect. Based on the published scientific evidence published to date, we summarized herein the effects of different potential therapies and up-to-date clinical trials. The review is intended to help readers aware of potentially effective COVID-19 treatment and provide useful references for future studies.

Keywords: COVID-19; Pharmacology; Pneumonia; SARS-CoV2.

Fig. 1

The mechanism of actions of different drugs against COVID-19. The figure illustrates the probable site of drugs effect during SARS-CoV2 infection including (1) binding and viral entry via membrane fusion or endocytosis (which are blocked by rhACE2, Bromhexine, Arbidol, Hydroxychloroquine, Ruxolitinib, and Baricitinib), (2) release of the viral genome, (3) translation of viral polymerase protein, (4) RNA replication, (5) genomic replication (which is inhibited by Oseltamivir and Emtricitabine), (6) translation of viral structural protein such as main proteases (which is inhibited by Atazanavir, Lopinavir, Darunavir, Danoprevir, and Noscapine), (7) capsidation and RNA-dependent RNA polymerase (which is inhibited by Remdesivir, Favipiravir, and Ribavirin), (8) formation of the mature virion, (9) exocytosis. Other recommended drugs act on immune responses such as Tocilizumab and Siltuximab (via inhibition of IL-6), interferon-alpha, and beta (as the immunoenhancement agents), Fingolimod and Thalidomide (as the immunomodulating agents). The figure is “Created with BioRender.com”