Therapeutic challenges of COVID-19: strategies of empirical treatment
Keywords:
SARS-CoV-2, COVID-19, Treatment, Antiviral, Remdesivir, Immunotherapy
Abstract
Coronavirus pandemic, is a progressing worldwide pandemic of coronavirus disease 2019 (COVID-19), brought about by sever acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The episode was first distinguished in Wuhan, China, in December 2019. The World Health Organization announced a Public Health Emergency of International Concern on 30 January 2020, and a pandemic on 11 March. Scientists around the world are working to establish an effective treatment against SARS-CoV-2 to control the spread of this pandemic. In this review, we summarized the potential therapeutic strategies for treatment of COVID-19 and dividing the treatments to several categories including antiviral drugs which act on decreasing the viral load inside the body of patients, immunotherapy and immunomodulatory which relive the inflammatory process of viral infection.
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References
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50. Say L, Paul C, Bing L, Manuel S. Elucidating the molecular physiopathology of acute respiratory distress syndrome in severe acute respiratory syndrome patients. Virus Res. 2009; 145(2): 260-269.
51. Masihi KN. Progress on novel immunomodulatory agents for HIV-1 infection and other infectious diseases. Expert Opin Ther Patents. 2003; 13(6): 867-882.
52. Frank LV, Mihai GN. Blocking IL-1 to prevent respiratory failure in COVID-19. Crit Care. 2020; 24(1): 1-6.
53. Giulio C, Giacomo DL, Corrado C, Emanuel D, Marco R, Diana C, et al. Interleukin-1 blockade with high-dose anakinra in patients with COVID-19, acute respiratory distress syndrome, and hyperinflammation: a retrospective cohort study. Lancet Rheumatol. 2020; 2: e325-331.
54. Cui-Cui CL, Xiao-Jia W, Hwa-Chain RW. Repurposing host-based therapeutics to control coronavirus and influenza virus. Drug Discov Today. 2019; 24(3): 726-736.
55. Ucciferri C, Auricchio A, Di Nicola M, Potere N, Abbate A, Cipollone F, et al. Canakinumab in a subgroup of patients with COVID-19. Lancet Rheumatol. 2020; 2(8): E457-EE458.
56. Elena B, Gregory N, Ana S, Jennifer B, Szu-Yuan P, Stanley W, et al. Anticancer kinase inhibitors impair intracellular viral trafficking and exert broad-spectrum antiviral effects. J Clin Invest. 2017; 127(4): 1338-1352.
57. Stebbing J, Phelan A, Griffin I, Tucker C, Oechsle O, Smith D, et al. COVID-19: combining antiviral and anti-inflammatory treatments. Lancet Infect Dis. 2020; 20: 400-402.
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2. Xiao-Wei X, Xiao-Xin W, Xian-Gao J, Kai-Jin X, Ling-Jun Y, Chun-Lian M, et al. Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series. BMJ. 2020; 368: m606.
3. Mohammed AH. Pathogenesis of IL-6 and potential therapeutic of IFN-γ. Eur J Biol Res. 2020; 10(4): 307-313.
4. Daniel W, Nianshuang W, Kizzmekia S, Corbett JA, Goldsmith CH, Olubukola A, et al. Cryo-EM structure of the 2019-nCoV spike in the prefusion conformation. Science. 2020; 367(6483): 1260-1263.
5. Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020; 579(7798): 270-273.
6. Jiang S, Hillyer C, Du L. Neutralizing antibodies against SARS-CoV-2 and other human Coronaviruses. Trends Immunol. 2020; 41(5): 355-359.
7. Belouzard S, Chu VC, Whittaker GR. Activation of the SARS coronavirus spike protein via sequential proteolytic cleavage at two distinct sites. Proc Nat Acad Sci. 2009; 106(14): 5871-5876.
8. Subramanian B, Adolfo BP, Ponmalai K. Novel 2019 coronavirus structure, mechanism of action, antiviral drug promises and rule out against its treatment. J Biomol Struct Dyn. 2020; 1-10.
9. Siu YL, Teoh KT, Lo J, Chan CM, Kien F, et al. The M, E, and N structural proteins of the severe acute respiratory syndrome coronavirus are required for efficient assembly, trafficking, and release of viruslike particles. J Virol. 2008; 82: 11318-11330.
10. Rabi FA, Al Zoubi MS, Kasasbeh GA, Salameh DM, Al-Nasser AD. SARS-CoV-2 and Coronavirus Disease 2019: what we know so far. Pathogens. 2020; 9: 231.
11. Cao D, Yuan Y, Zhang Y, Ma J, Qi J, Wang Q, Zhang X. Cryo-EM structures of MERS-CoV and
SARS-CoV spike glycoproteins reveal the dynamic receptor binding domains. Nat Commun. 2017; 8(1): 1-9.
12. Gui M, Song W, Zhou H, Xu, J, Chen S, Xiang Y, Wang X. Cryo-electron microscopy structures of the SARS-CoV spike glycoprotein reveal a prerequisite conformational state for receptor binding. Cell Res. 2017; 27(1): 119-129.
13. Kim YI, Kim SG, Kim SM, Kim EH, Park SJ, Yu KM, et al. Infection and rapid transmission of SARS-CoV-2 in ferrets. Cell Host Microbe. 2020; 27(5): 704-709.
14. Hoffmann M, Kleine-Weber H, Schroeder S, Kruger N, Herrler T, Erichsen S, et al. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and Is blocked by a clinically proven protease inhibitor. Cell. 2020; 181(2): 271-280. e278.
15. Fehr AR, Perlman S. Coronaviruses: an overview of their replication and pathogenesis. Coronaviruses. New York: Springer; 2015. P 1e23.
16. Wu A, Peng Y, Huang B, Ding X, Wang, X, Niu P, Sheng J, et al. Genome composition and divergence of the novel coronavirus (2019-nCoV) originating in China. Cell Host Microbe. 2020; 27: 325-328.
17. Sola I, Almazan F, Zuniga S, Enjuanes L. Continuous and discontinuous RNA synthesis in coronaviruses. Annu Rev Virol. 2015; 2: 265-288.
18. Paul SM. The molecular biology of coronaviruses. Adv Virus Res. 2006; 66: 193-292.
19. Anthony RF, Stanley P. Coronaviruses: An overview of their replication and pathogenesis. Methods Mol Biol. 2015; 1282: 1-23.
20. Mubasher R, Isfahan T, Bibi A, Sajid HS. Therapeutic and vaccine strategies against SARS-CoV-2: past, present and future. Future Virol. 2020; 15(7): 471-482.
21. Uzunova K, Filipova E, Pavlova V, Vekov T. Insights into antiviral mechanisms of remdesivir, lopinavir/ritonavir and chloroquine/hydroxychloroquine affecting the new SARS-CoV-2. Biomed Pharmacother. 2020; 131: 110668.
22. Hisham M, Anfal YA, Jaffar AA. A systematic review of therapeutic agents for the treatment of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). Travel Med Infect Dis. 2019; 30: 9-18.
23. Jianjun G, Zhenxue T, Xu Yang. Breakthrough: Chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies. Biosci Trends. 2020; 14(1): 72-73.
24. Sheahan TP, Sims AC, Leist SR, Schäfer A, Won J, Brown AJ, et al. Comparative therapeutic efficacy of remdesivir and combination lopinavir, ritonavir, and interferon beta against MERS-CoV. Nat Commun. 2020; 11(1): 222.
25. Blaising J, Polyak SJ, Pecheur EI. Arbidol as a broad-spectrum antiviral: an update. Antiviral Res. 2014; 107: 84-94.
26. Boriskin YS, Leneva IA, Pecheur EI, Polyak SJ. Arbidol: a broad-spectrum antiviral compound that blocks viral fusion. Curr Med Chem. 2008; 15(10): 997-1005.
27. Wrapp D, Wang N, Corbett KS, Goldsmith JA, Hsieh CL, Abiona O, et al. Cryo-EM structure of the 2019-nCoV spike in the prefusion conformation. Science. 2020; 367: 1260-3.
28. Vankadari N. Arbidol: A potential antiviral drug for the treatment of SARS-CoV-2 by blocking the trimerization of viral spike glycoprotein. Int J Antimicrob Agents. 2020; 56(2): 105998.
29. Yiwu Y, Zhen Z, Yang S, Xiao L, Kai-Feng Xu, Yuquan W, Ningyi J, Chengyu J. Anti-malaria drug chloroquine is highly effective in treating avian influenza A H5N1 virus infection in an animal model. Cell Res. 2013; 23(2): 300-302.
30. Savarino A, Di Trani L, Donatelli I, Cauda R, Cassone A. New insights into the antiviral effects of chloroquine. Lancet Infect Dis. 2006; 6(2): 67-69.
31. Eugenia QR, Giorgio B, Paola M, Isabella Z. The possible mechanisms of action of 4-aminoquinolines (chloroquine/hydroxychloroquine) against SARS-CoV-2 infection (COVID-19): A role for iron homeostasis. Pharmacol Res. 2020; 158: 104904.
32. Manli W, Ruiyuan C, Leike Z, Xinglou Y, Jia L, Mingyue X, et al. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Cell Res. 2020; 30: 269-271.
33. Philippe C, Jean-Marc R, Jean-Christophe L, Philippe B, Didier R. Chloroquine and hydroxychloroquine as available weapons to fight COVID-19. Int J Antimicrob Agents. 2020; 55(4): 105932.
34. Hajar O, Manica N, Nasim H. Immunotherapeutic approaches to curtail COVID-19. Int. Immunopharmacol. 2020; 88: 106924.
35. Winkler AM, Koepsell SA. The use of convalescent plasma to treat emerging infectious diseases: focus on Ebola virus disease. Curr Opin Hematol. 2015; 22(6): 521-526.
36. Bin Z, Shuyi L, Tan T, Wenhui H, Yuhao D, Luyan C, Qiuying C, et al. Treatment with convalescent plasma for critically ill patients with SARS-CoV-2 infection. Chest. 2020; 158 (1): e9-e13.
37. Marston HD, Paules CI, Fauci AS. Monoclonal antibodies for emerging infectious diseases borrowing from history. N Engl J Med. 2018; 378(16): 1469-1472.
38. Development of new crown virus antibody therapies by Regeneron. Instant Durg News, February 5, 2020.
39. Zeng Y, Xu X, He X, Tang S, Li Y, Huang Y, Harypursat V. Comparative effectiveness and safety of ribavirin plus interferon-alpha, lopinavir/ritonavir plus interferon-alpha, and ribavirin plus lopinavir/ritonavir plus interferon-alpha in patients with mild to moderate novel coronavirus disease 2019: study protocol. Chin Med J. 2020; 133(9): 1132-1134.
40. Mohammed, A. H. Pathogenesis of IL-6 and potential therapeutic of IFN-γ in COVID-19. Eur J Biol Res. 2020; 10(4): 307-313.
41. Chun-Kit Y, Joy-Yan L, Wan-Man W, Long-Fung M, Xiaohui W, Hin C, et al. SARS-CoV-2 nsp13, nsp14, nsp15 and orf6 function as potent interferon antagonists. Emerg Microbes Infect. 2020; 9(1): 1418-1428.
42. Farzaneh D, Seyed AN, Ali S, Majid M, Afshin M, Jamaati H, et al. Subcutaneous administration of Interferon beta-1a for COVID-19: A non-controlled prospective trial. Int. Immunopharmacol. 2020; 85: 106688.
43. Diagnosis and treatment protocol for novel coronavirus pneumonia (Trial Version 7). National Health Commission & National Administration of Traditional Chinese Medicine of the People’s Republic of China. 2020.
44. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020; 395(10229): 1054-1062.
45. Wang Z, Yang B, Li Q, Wen L, Zhang R. Clinical features of 69 cases with Coronavirus Disease 2019 in Wuhan, China. Clin Infect Dis. 2020; 71(15): 769-777.
46. Gritti G, Raimondi F, Ripamonti D, Riva I, Landi F, Alborghetti L, et al. Use of siltuximab in patients with COVID-19 pneumonia requiring ventilatory support. MedRxiv. 2020; doi: 10.1101/2020.04.01.20048561.
47. Robert QL, Liang L, Weishi Y, Stacy SS, Lei N, Bahru AH, et al. FDA approval summary: tocilizumab for treatment of chimeric antigen receptor T cell‐induced severe or life‐threatening cytokine release syndrome. Oncologist. 2018; 23(8): 943-947.
48. Xuetao C. COVID-19: immunopathology and its implications for therapy. Nat Rev Immunol. 2020; 20: 269-270.
49. Tom WJ, Roy MF, Martine J, Allen RR, Janet van A, Stefano F, et al. Sarilumab, a fully human monoclonal antibody against IL-6Rα in patients with rheumatoid arthritis and an inadequate response to methotrexate: efficacy and safety results from the randomised SARIL-RA-MOBILITY Part A trial. Ann Rheum Dis. 2014; 73(9): 1626-1634.
50. Say L, Paul C, Bing L, Manuel S. Elucidating the molecular physiopathology of acute respiratory distress syndrome in severe acute respiratory syndrome patients. Virus Res. 2009; 145(2): 260-269.
51. Masihi KN. Progress on novel immunomodulatory agents for HIV-1 infection and other infectious diseases. Expert Opin Ther Patents. 2003; 13(6): 867-882.
52. Frank LV, Mihai GN. Blocking IL-1 to prevent respiratory failure in COVID-19. Crit Care. 2020; 24(1): 1-6.
53. Giulio C, Giacomo DL, Corrado C, Emanuel D, Marco R, Diana C, et al. Interleukin-1 blockade with high-dose anakinra in patients with COVID-19, acute respiratory distress syndrome, and hyperinflammation: a retrospective cohort study. Lancet Rheumatol. 2020; 2: e325-331.
54. Cui-Cui CL, Xiao-Jia W, Hwa-Chain RW. Repurposing host-based therapeutics to control coronavirus and influenza virus. Drug Discov Today. 2019; 24(3): 726-736.
55. Ucciferri C, Auricchio A, Di Nicola M, Potere N, Abbate A, Cipollone F, et al. Canakinumab in a subgroup of patients with COVID-19. Lancet Rheumatol. 2020; 2(8): E457-EE458.
56. Elena B, Gregory N, Ana S, Jennifer B, Szu-Yuan P, Stanley W, et al. Anticancer kinase inhibitors impair intracellular viral trafficking and exert broad-spectrum antiviral effects. J Clin Invest. 2017; 127(4): 1338-1352.
57. Stebbing J, Phelan A, Griffin I, Tucker C, Oechsle O, Smith D, et al. COVID-19: combining antiviral and anti-inflammatory treatments. Lancet Infect Dis. 2020; 20: 400-402.
58. Richardson P, Griffin I, Tucker C, Smith D, Oechsle O, Phelan A, et al. Baricitinib as potential treatment for 2019-nCoV acute respiratory disease. Lancet. 2020; 395: e30-e31.
59. First patient outside U.S. treated in global Kevzara® (sarilumab) clinical trial program for patients with severe COVID-19. 2020. https://investor.regeneron.com/news-releases/news-release-details/first-patient-outside-us-treated-global-kevzarar-sarilumab
60. Hallie CP, Todd WR. Corticosteroids in COVID-19 ARDS: evidence and hope during the pandemic. Jama. 2020; 324(13): 1292-1295.
61. WHO updates guidance on corticosteroids in COVID-19 patients. 3 September 2020.
62. Zhenwei Y, Jialong L, Yunjiao Z, Xixian Z, Qiu Z, Jing L. The effect of corticosteroid treatment on patients with coronavirus infection: a systematic review and meta-analysis. J Infect. 2020; 81: e13-e20.
Published
2020-12-17
How to Cite
(1)
Mohammed, A.; Saber, A. Therapeutic Challenges of COVID-19: Strategies of Empirical Treatment. European Journal of Biological Research 2020, 11, 88-98.
Section
Review Articles
This work is licensed under a Creative Commons Attribution 4.0 International License.
