Using Existing Therapeutics Against COVID-19 | Biomol Blog | Resources

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Currently, there are no approved drugs to treat the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection that causes coronavirus disease 2019 (COVID-19). Existing drugs that have a known favorable safety profile are being examined for strategies to treat the disease and fast-track a treatment plan. The influenza drug favilavir (favipiravir; sold for research use only under the name T-705) has just been approved as an investigational therapy in the US, and the Ebola virus drug remdesivir is currently undergoing clinical trial in coronavirus patients in China. The rational selection of drugs already on the market is being made based on their ability to inhibit any proteins essential for virus-receptor interaction and/or viral life cycle.

Various potential targets for development of COVID-19 therapeutics exist along the stages from when a positive-sense, single-stranded RNA virus infects host cells and replicates. With little time available for drug testing and development, the repurposing of approved pharmaceutical drugs provides the most immediate solution for addressing the COVID-19 outbreak. Indeed, knowledge gained from the previous SARS outbreak has placed researchers in an advantageous position of better understanding solutions of how to address long-term treatment of this newly identified coronavirus.

Compound	Mechanism	Publications
Arbidol (Umifenovir)	Viral membrane fusion inhibitor	Arbidol Combined With LPV/r Versus LPV/r Alone Against Corona Virus Disease 2019 : a Retrospective Cohort Study
Camostat	Protease inhibitor	SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a 2 clinically-proven protease inhibitor
Cefuroximine	Multi-target inhibitor	Repurposing cefuroxime for treatment of COVID-19: a scoping review of in silico studies
Chloroquine (CQ) / Hydoxychloroquine	Zinc ionophore	Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro In Vitro Antiviral Activity and Projection of Optimized Dosing Design of Hydroxychloroquine for the Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Chloroquine Is a Zinc Ionophore
Fluoxetine	Viral replication inhibitor	The serotonin reuptake inhibitor Fluoxetine inhibits SARS-CoV-2
GS-441524	Antiviral adenosine analog	Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro
Ivermectin	IMPα/β1 inhibitor	The FDA-approved Drug Ivermectin inhibits the replication of SARS-CoV-2 in vitro
MK-2206	AKT inhibitor	Analysis of SARS-CoV-2-controlled autophagy reveals spermidine, MK-2206, and niclosamide as putative antiviral therapeutics
Lopinavir / Ritonavir (Kaletra, LPV/r)	CYP enzyme inhibitor	Role of lopinavir/ritonavir in the treatment of SARS: initial virological and clinical findings
Nafamostat	Protease inhibitor	Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro
NHC, EIDD-1931	Antiviral ribonucleoside analog	An orally bioavailable broad-spectrum antiviral inhibits SARS-CoV-2 and multiple endemic, epidemic and bat coronavirus
Niclosamide	Beclin-1 stabilizer	Analysis of SARS-CoV-2-controlled autophagy reveals spermidine, MK-2206, and niclosamide as putative antiviral therapeutics
Nitazoxanide	Antiviral	Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro
Penciclovir	Antiviral guanosine analog	Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro
Remdesivir (GS-5734, RDV)	Prodrug form of GS-441524	Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro Compassionate Use of Remdesivir for Patients with Severe Covid-19
Ribavirin	Antiviral guanosine analog	Inhibition of SARS Coronavirus Infection In Vitro with Clinically Approved Antiviral Drugs Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro
Spermidine	Autophagy inducer	Analysis of SARS-CoV-2-controlled autophagy reveals spermidine, MK-2206, and niclosamide as putative antiviral therapeutics
T-705 (Favipiravir)	RdRP inhibitor	Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro T-705 induces lethal mutagenesis in Ebola and Marburg populations in macaques
Zinc	RdRP inhibitor	Zn2+ Inhibits Coronavirus and Arterivirus RNA Polymerase Activity In Vitro and Zinc Ionophores Block the Replication of These Viruses in Cell Culture Chloroquine Is a Zinc Ionophore

Photo Credit

Alissa Eckert, MS, Dan Higgins, MAMS

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