Repurposing therapeutic agents against SARS-CoV-2 infection: most promising and neoteric progress

ABSTRACT

Introduction

The pathogenic and highly transmissible etiological agent, SARS-CoV-2, has caused a serious threat COVID-19 pandemic. WHO has declared the epidemic a public health emergency of international concern owing to its high contagiosity, mortality rate, and morbidity. Till now, there is no approved vaccine or drug to combat the COVID-19 and avert this global crisis.

Areas covered

In this narrative review, we summarized the updated results (January to August 2020) of the most promising repurposing therapeutic candidates to treat the SARS-CoV-2 viral infection. The repurposed drugs classified under four headlines like antivirals, anti-parasitic, immune-modulating, and miscellaneous drugs were discussed with their in vitro efficacy to recent clinical advancements against COVID-19.

Expert opinion

Currently, palliative care, ranging from outpatient management to intensive care, including oxygen administration, ventilator support, intravenous fluids therapy, with some repurposed drugs, are the primary weapons to fight against COVID-19. Until a safe and effective vaccine is developed, an evidence-based drug repurposing strategy might be the wisest option to save people from this catastrophe. Several existing drugs are now under clinical trials, and some of them are approved in different places of the world for emergency use or as adjuvant therapy in COVID-19 with standard of care.

KEYWORDS:

• SARS-CoV-2
• covid-19 pandemic
• public health crisis
• palliative care
• repurposing strategy
• clinical trials

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Author contributions

Md. Jamal Hossain conceptualized, searched and collected data, and drafted the original manuscript. S. M. Abdur Rahman instructed and edited the manuscript critically. Both authors revised and approved the final version of the manuscript for submission.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Article highlights

• In December 2019, the Wuhan city of China faced a novel virus with atypical secondary pneumonia, and the World Health Organization has declared this viral infection as a pandemic owing to its high contagiosity, mortality rate, and morbidity.

• As a vaccine or a new drug discovery is laborious and requires a long time, repurposing existing drugs might be an effective way to battle this pandemic.

• Meanwhile, several antivirals, anti-parasitic, immune-modulating, and some other promising drugs have been traced and are now under clinical trials to identify an effective and safe drug against COVID-19.

• Some repurposed drugs are being approved in several countries for emergency use or adjuvant therapy in COVID-19 in addition to standard of care.

• Researchers, health professionals, public health experts, and authorities must speculate to find the best way to fight the current or future epidemic.

• Drug discovery or vaccine development should be emphasized by concerted efforts to prevent the virus transmission.

Additional information

Funding

This paper was not funded.