Last Updated on June 16, 2020 by Sagar Aryal

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Image Source: Biorender and ARTIS Ventures

Rescue treatment involving convalescent plasma andare also delivered to some critical cases according to their conditions.

Many of the patients have accepted oxygen therapy, and the WHO has recommended extracorporeal membrane oxygenation (ECMO) to patients with refractory hypoxemia.

Regarding patients infected with COVID-19, it has been recommended to apply appropriate symptomatic treatment and supportive care.

Currently, no specific antiviral treatment has been confirmed to be effective against COVID-19.

Image Source: ARTIS Ventures

These include the clinical candidate EIDD-2801 compound that has shown high therapeutic potential against seasonal and pandemic influenza virus infections and this represents another potential drug to be considered for the treatment of COVID-19 infection.

Furthermore, several other compounds are in development.

The only option available is using broad-spectrum antiviral drugs like Nucleoside analogs and also HIV-protease inhibitors that could alleviate virus infection until the specific antiviral becomes available.

Image Source: ARTIS Ventures

Remdesivir is a 1′-cyano-substituted adenosine nucleotide analog prodrug and shows broad-spectrum antiviral activity against several RNA viruses.

Remdesivir has been reported to be used for the treatment of a few cases of COVID-19 successfully.

The protease inhibitors, lopinavir, and ritonavir used to treat the infection with human immunodeficiency virus (HIV), MERS-CoV and SARS-CoV patients have been reported to significantly reduce the β-coronavirus viral loads of COVID-19 patients after treatment with these drugs.

A combination of remdesivir and chloroquine was proven to inhibit the recently emerged SARS-CoV-2 in vitro effectively.

Several studies have found that chloroquine interfered with the glycosylation of cellular receptors of SARS-CoV and functioned at both entry and post-entry stages of the COVID-19 infection in Vero E6 cells.

Moreover, chloroquine has immunomodulatory effects, suppressing the production/release of TNF-α and IL-6 and also works as a novel class of autophagy inhibitor, which may interfere with viral infection and replication.

It has been assumed that chloroquine can inhibit pH-dependent steps of the replication of several viruses, with a potent effect on infection and the spread of SARS-CoV-2.

Chloroquine has been in use for many years for the treatment of malaria, with a mechanism not well understood against some viral infections.

Chloroquine (Hydroxychloroquine) is another repurposed drug that shows great potential for the treatment of COVID-19.

Ivermectin is an FDA-approved broad-spectrum anti-parasitic agent that has shown to have antiviral activity against a broad range of viruses in vitro.

Ivermectin is an inhibitor of the causative virus (SARS-CoV-2) able to effect ∼a 5000-fold reduction in viral RNA at 48 hours.

Ivermectin has been confirmed to inhibit nuclear import and HIV-1 replication.

It has been shown to inhibit the nuclear import of host and viral proteins in many RNA viruses like dengue virus (DENV), West Nile Virus, and Venezuelan equine encephalitis virus (VEEV).

This broad-spectrum activity is believed to be due to the involvement of IMPα/β1 during infection in the case of many different RNA viruses.

It has been assumed that ivermectin acts through inhibiting IMPα/β1-mediated nuclear import of viral proteins, as shown for other RNA viruses.

The confirmation of this mechanism in the case of SARS-CoV-2 and the identification of the specific SARS-CoV-2 and host components impacted is yet to be done.