College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates.
Clinical Biochemistry and Molecular Biology Unit, Cancer Biology department, National Cancer Institute, Cairo University, Egypt.
Biomed Pharmacother. 2021 Nov;143:112107. doi: 10.1016/j.biopha.2021.112107. Epub 2021 Aug 27.
The coronavirus disease 2019 (COVID-19) pandemic caused and is still causing significant mortality and economic consequences all over the globe. As of today, there are three U.S Food and Drug administration (FDA) approved vaccines, Pfizer-BioNTech, Moderna and Janssen COVID-19 vaccine. Also, the antiviral drug remdesivir and two combinations of monoclonal antibodies are authorized for Emergency use (EUA) in certain patients. Furthermore, baricitinib was approved in Japan (April 23, 2021). Despite available vaccines and EUA, pharmacological therapy for the prevention and treatment of COVID-19 is still highly required. There are several ongoing clinical trials investigating the efficacy of clinically available drugs in treating COVID-19. In this study, selected novel pharmacological agents for the possible treatment of COVID-19 will be discussed. Point of discussion will cover mechanism of action, supporting evidence for safety and efficacy and reached stage in development. Drugs were classified into three classes according to the phase of viral life cycle they target. Phase I, the early infective phase, relies on supportive care and symptomatic treatment as needed. In phase II, the pulmonary phase, treatment aims at inhibiting viral entry or replication. Drugs used during this phase are famotidine, monoclonal antibodies, nanobodies, ivermectin, remdesivir, camostat mesylate and other antiviral agents. Finally, phase III, the hyper-inflammatory phase, tocilizumab, dexamethasone, selective serotonin reuptake inhibitors (SSRI), and melatonin are used. The aim of this study is to summarize current findings and suggest gaps in knowledge that can influence future COVID-19 treatment study design.
2019 年冠状病毒病（COVID-19）大流行在全球范围内造成并仍在造成重大的死亡率和经济后果。截至今日，有三种美国食品和药物管理局（FDA）批准的疫苗，辉瑞-生物技术公司、莫德纳和强生 COVID-19 疫苗。此外，抗病毒药物瑞德西韦和两种单克隆抗体组合被授权在某些患者中紧急使用（EUA）。此外，巴瑞替尼在日本获得批准（2021 年 4 月 23 日）。尽管有可用的疫苗和 EUA，但预防和治疗 COVID-19 的药物治疗仍然非常需要。有几项正在进行的临床试验正在研究临床可用药物治疗 COVID-19 的疗效。在这项研究中，将讨论几种用于 COVID-19 治疗的新型药理学药物。讨论的重点将包括作用机制、安全性和疗效的支持证据以及开发阶段。根据药物针对的病毒生命周期阶段，将药物分为三类。第 I 阶段，早期感染阶段，依赖于支持性护理和按需对症治疗。在第 II 阶段，肺部阶段，治疗旨在抑制病毒进入或复制。在此阶段使用的药物有法莫替丁、单克隆抗体、纳米抗体、伊维菌素、瑞德西韦、甲磺酸卡马西平和其他抗病毒药物。最后，第 III 阶段，过度炎症阶段，使用托珠单抗、地塞米松、选择性 5-羟色胺再摄取抑制剂（SSRIs）和褪黑素。本研究旨在总结当前的发现，并提出可能影响未来 COVID-19 治疗研究设计的知识空白。
