Saha Ankita, Choudhary Shweta, Walia Priyanshu, Kumar Pravindra, Tomar Shailly
Department of Biosciences and Bioengineering, Indian Institute of Technology Roorkee, Uttarakhand, 247667, India.
Department of Biosciences and Bioengineering, Indian Institute of Technology Roorkee, Uttarakhand, 247667, India.
Virology. 2025 Mar;604:110394. doi: 10.1016/j.virol.2025.110394. Epub 2025 Jan 10.
The global healthcare and economic challenges caused by the pandemic of COVID-19 reinforced the urgent demand for quick and effective therapeutic and preventative interventions. While vaccines served as the frontline of defense, antivirals emerged as adjunctive countermeasures, especially for people who developed infection, were immunocompromised, or were reluctant to be vaccinated. Beyond the serious complications of SARS-CoV-2 infection, the threats of long-COVID and the potential for zoonotic spillover continue to be significant health concerns that cannot be overlooked. Moreover, the incessant viral evolution, clinical safety issues, waning immune responses, and the emergence of drug-resistant variants pinpoint towards more severe viral threats in the future and call for broad-spectrum innovative therapies as a pre-pandemic preparedness measure. The present review provides a comprehensive up-to-date overview of the strategies utilized in the development of classical and next-generation vaccines against SARS-CoV-2, the clinical and experimental data obtained from clinical trials, while addressing safety risks that may arise. Besides vaccines, the review also covers recent breakthroughs in anti-SARS-CoV-2 drug discovery, emphasizing druggable viral and host targets, virus- and host-targeting antivirals, and highlighting mechanistically representative molecules that are either approved or are under clinical investigation. In conclusion, the integration of both vaccines and antiviral therapies, along with swift innovative strategies to address viral evolution and drug resistance is crucial to strengthen our preparedness against future viral outbreaks.
由新冠疫情引发的全球医疗保健和经济挑战,凸显了对快速有效的治疗和预防干预措施的迫切需求。疫苗作为主要防御手段,抗病毒药物则成为辅助应对措施,特别是对于那些感染新冠病毒、免疫功能低下或不愿接种疫苗的人群。除了新冠病毒感染的严重并发症外,长期新冠的威胁以及人畜共患病溢出的可能性仍然是不容忽视的重大健康问题。此外,病毒的不断进化、临床安全问题、免疫反应减弱以及耐药变异株的出现,都表明未来将面临更严峻的病毒威胁,因此需要采用广谱创新疗法作为大流行前的防范措施。本综述全面且及时地概述了针对新冠病毒的经典疫苗和新一代疫苗研发所采用的策略、临床试验获得的临床和实验数据,同时探讨了可能出现的安全风险。除疫苗外,该综述还涵盖了抗新冠病毒药物研发的最新突破,重点介绍了可成药的病毒和宿主靶点、针对病毒和宿主的抗病毒药物,并突出了已获批或正在进行临床研究的具有代表性机制的分子。总之,整合疫苗和抗病毒疗法,以及迅速采取创新策略应对病毒进化和耐药性,对于加强我们对未来病毒爆发的防范至关重要。