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An Update on Antiviral Therapy Against SARS-CoV-2: How Far Have We Come?
Front Pharmacol. 2021; 12:632677.FP

Abstract

COVID-19 pandemic has spread worldwide at an exponential rate affecting millions of people instantaneously. Currently, various drugs are under investigation to treat an enormously increasing number of COVID-19 patients. This dreadful situation clearly demands an efficient strategy to quickly identify drugs for the successful treatment of COVID-19. Hence, drug repurposing is an effective approach for the rapid discovery of frontline arsenals to fight against COVID-19. Successful application of this approach has resulted in the repurposing of some clinically approved drugs as potential anti-SARS-CoV-2 candidates. Several of these drugs are either antimalarials, antivirals, antibiotics or corticosteroids and they have been repurposed based on their potential to negate virus or reduce lung inflammation. Large numbers of clinical trials have been registered to evaluate the effectiveness and clinical safety of these drugs. Till date, a few clinical studies are complete and the results are primary. WHO also conducted an international, multi-country, open-label, randomized trials-a solidarity trial for four antiviral drugs. However, solidarity trials have few limitations like no placebos were used, additionally any drug may show effectiveness for a particular population in a region which may get neglected in solidarity trial analysis. The ongoing randomized clinical trials can provide reliable long-term follow-up results that will establish both clinical safety and clinical efficacy of these drugs with respect to different regions, populations and may aid up to worldwide COVID-19 treatment research. This review presents a comprehensive update on majorly repurposed drugs namely chloroquine, hydroxychloroquine, remdesivir, lopinavir-ritonavir, favipiravir, ribavirin, azithromycin, umifenovir, oseltamivir as well as convalescent plasma therapy used against SARS-CoV-2. The review also summarizes the data recorded on the mechanism of anti-SARS-CoV-2 activity of these repurposed drugs along with the preclinical and clinical findings, therapeutic regimens, pharmacokinetics, and drug-drug interactions.

Authors+Show Affiliations

Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Indore, India.Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Indore, India.School of Pharmacy, Devi Ahilya Vishwavidyalaya, Indore, India.Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Indore, India.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

33762954

Citation

Indari, Omkar, et al. "An Update On Antiviral Therapy Against SARS-CoV-2: How Far Have We Come?" Frontiers in Pharmacology, vol. 12, 2021, p. 632677.
Indari O, Jakhmola S, Manivannan E, et al. An Update on Antiviral Therapy Against SARS-CoV-2: How Far Have We Come? Front Pharmacol. 2021;12:632677.
Indari, O., Jakhmola, S., Manivannan, E., & Jha, H. C. (2021). An Update on Antiviral Therapy Against SARS-CoV-2: How Far Have We Come? Frontiers in Pharmacology, 12, 632677. https://doi.org/10.3389/fphar.2021.632677
Indari O, et al. An Update On Antiviral Therapy Against SARS-CoV-2: How Far Have We Come. Front Pharmacol. 2021;12:632677. PubMed PMID: 33762954.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - An Update on Antiviral Therapy Against SARS-CoV-2: How Far Have We Come? AU - Indari,Omkar, AU - Jakhmola,Shweta, AU - Manivannan,Elangovan, AU - Jha,Hem Chandra, Y1 - 2021/03/08/ PY - 2020/11/23/received PY - 2021/01/15/accepted PY - 2021/3/25/entrez PY - 2021/3/26/pubmed PY - 2021/3/26/medline KW - COVID-19 KW - SARS-CoV-2 KW - antivirals KW - drug repurposing KW - mechanism of action KW - pharmacokinetics SP - 632677 EP - 632677 JF - Frontiers in pharmacology JO - Front Pharmacol VL - 12 N2 - COVID-19 pandemic has spread worldwide at an exponential rate affecting millions of people instantaneously. Currently, various drugs are under investigation to treat an enormously increasing number of COVID-19 patients. This dreadful situation clearly demands an efficient strategy to quickly identify drugs for the successful treatment of COVID-19. Hence, drug repurposing is an effective approach for the rapid discovery of frontline arsenals to fight against COVID-19. Successful application of this approach has resulted in the repurposing of some clinically approved drugs as potential anti-SARS-CoV-2 candidates. Several of these drugs are either antimalarials, antivirals, antibiotics or corticosteroids and they have been repurposed based on their potential to negate virus or reduce lung inflammation. Large numbers of clinical trials have been registered to evaluate the effectiveness and clinical safety of these drugs. Till date, a few clinical studies are complete and the results are primary. WHO also conducted an international, multi-country, open-label, randomized trials-a solidarity trial for four antiviral drugs. However, solidarity trials have few limitations like no placebos were used, additionally any drug may show effectiveness for a particular population in a region which may get neglected in solidarity trial analysis. The ongoing randomized clinical trials can provide reliable long-term follow-up results that will establish both clinical safety and clinical efficacy of these drugs with respect to different regions, populations and may aid up to worldwide COVID-19 treatment research. This review presents a comprehensive update on majorly repurposed drugs namely chloroquine, hydroxychloroquine, remdesivir, lopinavir-ritonavir, favipiravir, ribavirin, azithromycin, umifenovir, oseltamivir as well as convalescent plasma therapy used against SARS-CoV-2. The review also summarizes the data recorded on the mechanism of anti-SARS-CoV-2 activity of these repurposed drugs along with the preclinical and clinical findings, therapeutic regimens, pharmacokinetics, and drug-drug interactions. SN - 1663-9812 UR - https://www.unboundmedicine.com/medline/citation/33762954/An_Update_on_Antiviral_Therapy_Against_SARS-CoV-2:_How_Far_Have_We_Come L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/33762954/ DB - PRIME DP - Unbound Medicine ER -
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