Overview Overview Overview
The recently emerging Covid-19 infection has spread rapidly around the world and has evolved into a pandemic. The virus has infected millions of people around the world and has killed many people across countries. Healthcare professionals around the world are working to discover new treatment options that can help patients with COVID-19. Based on the study, doctors and scientists have classified various classes of drugs such as remdesivir, hydroxychloroquine, ritonavir or ropinavir, and ribavirin as effective treatments for COVID-19 patients.
What are the potential treatment options for COVID-19 patients?
Currently, most of the treatment options available to COVID-19 patients are aimed at prevention and supportive care of complications such as organ failure. Scientists and doctors are doing their best to find treatment options for COVID-19 patients. These treatment options fall into two categories:
- Research on available drugs that may have antiviral effects on COVID-19
- Development of new drugs to help specifically target coronavirus and other host factors
DevelopIt can take several years to develop a new drug for COVID-19 and get approval for it to be used in humans. In the current situation, waiting a few years can be even more damaging. As a result, scientists are trying to reuse already available antivirals that are effectively used to treat other viral infections and illnesses. This may be an excellent therapeutic option, as the pharmacokinetics and pharmacodynamic properties, dosages, and side effects of these antiviral agents are already known. Different categories of drugs are classified to help treat COVID-19. They are:
- Direct-acting antiviral agents
- Host targeting antiviral drug
- Immunosuppressive or immunomodulatory treatment
- Biological therapy
- Direct-acting antiviral agents.. Direct-acting antiviral drugs include remdesivir, HIV-1 protease inhibitors, and other drugs such as favipiravir, baloxavir, and triazavirin.
Ribavirin is a widespread antiviral drug. It showed moderate antiviral activity against SARS-CoV infection. However, some studies have found that the drug has no significant effect on SARS-CoV replication.
Remdesivir, used against Ebola and Marburg viruses, is a nucleotide analog RNA-dependent RNA polymerase (RdRp) inhibitor. The drug has broad spectrum anti-coronavirus activity because it has been effective in the past for the treatment of viral infections of zoonotic diseases.
Another potential candidate for the treatment of COVID-19 is an HIV-1 protease inhibitor. These include nelfinavir, saquinavir, emtricitabine / tenofovir, darunavir / cobicistat, and azbudin. Nelfinavir is effective in inhibiting the replication of coronavirus in vitro.
Other antiviral drugs such as baloxavir, favipiravir, triazavirin, danoprevir / ritonavir, and malvoxil are also being studied. These drugs have been successful in treating many influenza subtypes and hepatitis C virus infections. One study reported that danoprevir / ritonavir alleviated COVID-19 symptoms in many patients.
- Host targeting antiviral agent. Traditional antimalarial drugs such as chloroquine and hydroxychloroquine have proven effective against coronavirus replication in vitro. These drugs work by providing protection against the invasion of the virus and its further replication. Several small studies and one subjective report have revealed the effectiveness of these drugs against coronavirus infection.
- Immunosuppressive or immunomodulatory treatment. A protein called interferon helps restore the innate immune response of the body’s host cells. They are also effective in inhibiting the replication of coronavirus. Combining interferon with other antiviral drugs such as lopinavir / ritonavir and ribavirin has effectively treated MERS and SARS in the past.
Scientists believe that the severity of COVID-19 may be associated with an excessive inflammatory response called a cytokine storm. This makes immunosuppressive and immunomodulatory agents such as intravenous immunoglobulins and corticosteroids potential therapeutic candidates for COVID-19 treatment.
- Biological therapy. This treatment option has been successful in treating MERS and SARS and may be a potential candidate for COVID-19 patients.
Development of new agent
In addition to the potential treatment options already available, the development of new antiviral agents that specifically target coronavirus should also be considered. It is believed that these may theoretically have better anti-coronavirus activity. However, it must first be evaluated in animal studies and then in human studies. This can take several years.
- Viral nucleic acid
- Structural protein
- Host-dependent target
- Viral nucleic acid. Drugs that target nucleic acids exhibit broad spectrum activity. These drugs can target several types of viruses. An inhibitor called mycophenolate mofetil has shown effective antiviral activity against MERS.
- Structural protein. Coronavirus spike glycoproteins have two functional subunits called S1 and S2. These subunits are involved in viral etiology, tissue tropism, and cell receptor binding. These subunits are the primary targets when designing vaccines and therapeutics.
- A host-dependent target. Host factors that play an integral role in the viral life cycle have been identified as targets for antiviral agents. N- (2-aminoethyl) -1-aziridine-ethaneamine, a small inhibitor in the form of a molecule, is thought to inhibit the catalytic activity of viral fusion with human cells.
Another potential therapeutic option for COVID-19 is the host cell signaling pathway. The phosphoinositol 3-kinase / serine-threonine kinase / mammalian rapamycin target (mTOR) signaling response is known to play an important role in the treatment of MERS-coronavirus infections. Several recent studies have shown that combining the mTOR pathway with AMP-activated protein kinase may help control the development of hyperinflammation, cell damage, oxidative stress, and mitochondrial dysfunction. It was. This makes targeting the mTOR pathway an effective antiviral therapy in the treatment of COVID-19.