1. Emerging pharmacotherapies for COVID-19
- Author
-
Panini Patankar and Rachana Salvi
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Pneumonia, Viral ,Anti-Inflammatory Agents ,Remdesivir ,Disease ,RM1-950 ,Antiviral Agents ,Article ,03 medical and health sciences ,chemistry.chemical_compound ,Antimalarials ,Betacoronavirus ,0302 clinical medicine ,Tocilizumab ,Pandemic ,Drug Discovery ,medicine ,Humans ,Immunologic Factors ,Intensive care medicine ,Pandemics ,ComputingMethodologies_COMPUTERGRAPHICS ,Pharmacology ,Anakinra ,Respiratory distress ,business.industry ,SARS-CoV-2 ,Drug Repositioning ,COVID-19 ,Hydroxychloroquine ,Chloroquine ,General Medicine ,medicine.disease ,COVID-19 Drug Treatment ,Pneumonia ,030104 developmental biology ,chemistry ,030220 oncology & carcinogenesis ,Therapeutics. Pharmacology ,business ,Cytokine storm ,Coronavirus Infections ,Cytokine Release Syndrome ,medicine.drug - Abstract
Graphical abstract, Highlights • Corona Virus Disease (COVID 19) is caused by novel corona virus (nCoV) and may lead to fatality due to Severe Acute Respiratory Syndrome (SARS) in susceptible individuals. • As it is a rapidly evolving situation, rather than developing new drugs, many drugs have been repurposed and are potentially used either prophylactically or therapeutically throughout the world. • SOLIDARITY trial by WHO promotes clinical trial with respect to four potentially useful repurposed drugs namely Chloroquine and hydroxychloroquine, Remdesivir, Lopinavir and Ritonavir combination with or without interferon β. • The drugs mentioned in SOLIDARITY trial are mainly antivirals also used as anti-HIV drugs except for chloroquine and hydroxychloroquine which are anti-malarial drugs which are believed to act through interfering with glycosylation of receptor. • Convalescent plasma therapy is an evolving therapy based on the principle of passive immunity. • As inflammation and cytokine storm is believed to lead to deterioration in patients of COVID 19, anti-cytokine medications are also under research., Novel Corona-virus Disease 2019 (nCOVID 19) is caused by a novel virulent corona virus and leads to potentially fatal virulent pneumonia and severe respiratory distress syndrome. It was initially declared as public health emergency if international concern by WHO followed by Pandemic on 12th March 2020. As of 10th April 2020, more than 1.5 million people are affected globally with around 95000 deaths. Vaccines for this deadly virus are currently under development and many drugs used for other indications have been repurposed and investigated for prophylaxis and treatment of COVID 19. As per SOLIDARITY trial by WHO, some of the most promising candidates include chloroquine phosphate and hydroxychloroquine which are anti-malarial medications, Remdesivir, Lopinavir-Ritonavir combination with or without interferon which are anti-HIV drugs and convalescent plasma therapy. The current evidence of efficacy and ongoing research has been elaborated in the article. Besides, there has been evidence regarding inflammatory pathogenesis of this virus leading to cytokine storm in susceptible individuals. Thus, anti-proinflammatory cytokine drugs like Anakinra and Tocilizumab are undergoing multiple trials and some results are encouraging. Similarly, use of anti-inflammatory cytokines like IL-37 and IL-38 is hypothesised to be useful and is under research. The situation is still evolving and hence there is yet no definitive therapy but to conclude the use of repurposed medications can be a boon till a definitive therapy and vaccines are developed.
- Published
- 2020