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What are the current anti-COVID-19 drugs? From traditional to smart molecular mechanisms
Sawsan Aboul-Fotouh1,2, Ahmed Nageh Mahmoud1, Esraa M Elnahas1
1Department of Clinical Pharmacology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Background:
Coronavirus disease 19 (COVID-19) is the disease caused by SARS-CoV-2, a highly infectious member of the coronavirus family, which emerged in December 2019 in "Wuhan, China". It induces respiratory illness ranging from mild symptoms to severe disease. It was declared a "pandemic" by the World Health Organization (WHO) in March 2020. Since then, a vast number of clinical and experimental studies have been conducted to identify effective approaches for its prevention and treatment.
Main Body:
The pathophysiology of COVID-19 represents an unprecedented challenge; it triggers a strong immune response, which may be exacerbated by "a cytokine storm syndrome". It also induces thrombogenesis and may trigger multi-organ injury. Therefore, different drug classes have been proposed for its treatment and prevention, such as antivirals, anti-SARS-CoV-2 antibody agents (monoclonal antibodies, convalescent plasma, and immunoglobulins), anti-inflammatory drugs, immunomodulators, and anticoagulant drugs. To the best of our knowledge, this review is the first to present, discuss, and summarize the current knowledge about the different drug classes used for the treatment of COVID-19, with special emphasis on their targets, mechanisms of action, and important adverse effects and drug interactions. Additionally, we spotlight the latest "October 2023" important guidelines (NIH, IDSA, and NICE) and FDA approval or authorization regarding the use of these agents in the management of COVID-19.
Conclusion:
Despite the wide array of therapeutic strategies introduced for the treatment of COVID-19, one of the most prominent therapeutic challenges is SARS-CoV-2 mutations and emerging new variants and subvariants. Currently, the anti-COVID-19 drug pipeline is continuously affording novel treatments to face this growing challenge.
Insights
This review summarizes current COVID-19 treatments, including antivirals and immunomodulators, detailing their mechanisms, side effects, and interactions. It also highlights recent guidelines and FDA approvals for managing SARS-CoV-2 infection.
Area of Science:
- Infectious Diseases
- Pharmacology
- Immunology
Background:
- Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, emerged in late 2019, leading to a global pandemic characterized by respiratory illness.
- The disease can cause severe symptoms, including a cytokine storm, thrombogenesis, and multi-organ injury, necessitating diverse therapeutic interventions.
Purpose of the Study:
- To review and synthesize current knowledge on various drug classes used for COVID-19 treatment.
- To emphasize drug targets, mechanisms of action, adverse effects, and drug interactions.
- To highlight recent (October 2023) guidelines and FDA approvals for COVID-19 therapeutics.
Main Methods:
- Comprehensive literature review of clinical and experimental studies on COVID-19 treatments.
- Analysis of drug classes including antivirals, antibody agents, anti-inflammatories, immunomodulators, and anticoagulants.
- Inclusion of information on recent guidelines from NIH, IDSA, and NICE, and FDA authorizations.
Main Results:
- Multiple drug classes are employed for COVID-19, targeting different aspects of SARS-CoV-2 infection and its complications.
- Key considerations include drug efficacy, safety profiles, potential adverse events, and drug-drug interactions.
- Recent guidelines and FDA approvals provide updated recommendations for therapeutic use.
Conclusions:
- The evolving nature of SARS-CoV-2, including mutations and new variants, presents an ongoing therapeutic challenge.
- The drug development pipeline continues to introduce novel treatments to combat the dynamic threat of COVID-19.
- Effective management of COVID-19 requires a thorough understanding of available therapies and their appropriate application.
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