Abstract
The strategy of drug repurposing has been proved successful in response to the current coronavirus pandemic, with remdesivir becoming the first drug of choice, an antiviral drug approved for the treatment of COVID-19. In parallel to this, several drugs, such as antimalarial, corticosteroids, and antibiotics, like azithromycin, are used to treat the severe condition of hospitalized COVID-19 patients, while clinical testing of additional therapeutic drugs, including vaccines, is going on. It is reasonably expected that this review article will deliver optimized and specific curative tools that will increase the attentiveness of health systems to the probable outlook of epidemics in the future. This review focuses on the application of repurposed drugs by studying their structure, pharmacokinetic study, different mechanisms of action, and Covid-19 guidelines, which can potentially influence SARS-CoV-2. For most of the drugs, direct clinical evidence regarding their effectiveness in the treatment of COVID-19 is missing. Future clinical trial studies may conclude that one of these can be more potential to inhibit the progression of COVID-19.
Keywords: COVID-19, drug repurposing, antiviral, antimalarial, corticosteroids, SARS-CoV, remdesivir.
Graphical Abstract
[http://dx.doi.org/10.4155/fmc.11.95] [PMID: 21879845]
[http://dx.doi.org/10.1002/med.21315] [PMID: 24659483]
[http://dx.doi.org/10.3389/fimmu.2019.00531] [PMID: 30941148]
[http://dx.doi.org/10.1164/rccm.201706-1172OC] [PMID: 29161116]
[http://dx.doi.org/10.3390/v7102868] [PMID: 26426038]
[http://dx.doi.org/10.1056/NEJM199011223232104] [PMID: 2233917]
[http://dx.doi.org/10.1136/ard.2010.146225] [PMID: 21613310]
[http://dx.doi.org/10.1080/14740338.2017.1269168] [PMID: 27927040]
[http://dx.doi.org/10.1016/j.ejps.2017.10.027] [PMID: 29079337]
[http://dx.doi.org/10.3390/v10090454] [PMID: 30149615]
[http://dx.doi.org/10.3389/fonc.2019.00852] [PMID: 31552177]
[http://dx.doi.org/10.1038/s41392-021-00527-1] [PMID: 33686059]
[http://dx.doi.org/10.1001/jama.2020.16349] [PMID: 32821939]
[http://dx.doi.org/10.5582/ddt.2020.01012] [PMID: 32147628]
[http://dx.doi.org/10.1016/j.jhep.2015.07.041] [PMID: 26325535]
[http://dx.doi.org/10.1074/jbc.AC120.015720] [PMID: 32967965]
[http://dx.doi.org/10.3762/bjoc.13.74] [PMID: 28503210]
[http://dx.doi.org/10.4269/ajtmh.21-0606] [PMID: 34649223]
[http://dx.doi.org/10.1089/108729103322395465] [PMID: 14588081]
[http://dx.doi.org/10.1056/NEJMoa2021436] [PMID: 32678530]
[http://dx.doi.org/10.1056/NEJMoa2022926] [PMID: 33031652]
[http://dx.doi.org/10.1016/j.antiviral.2014.04.006] [PMID: 24769245]
[http://dx.doi.org/10.1016/j.cgh.2005.12.020] [PMID: 16527695]
[http://dx.doi.org/10.1038/s41421-020-0156-0] [PMID: 32194981]
[http://dx.doi.org/10.1056/NEJMoa2007764] [PMID: 32445440]
[http://dx.doi.org/10.1097/01.TP.0000114610.40412.C6] [PMID: 15084936]
[http://dx.doi.org/10.1016/j.isci.2019.07.003] [PMID: 31402258]
[http://dx.doi.org/10.1038/d41573-020-00073-5] [PMID: 32273591]
[http://dx.doi.org/10.1056/NEJMoa2019014] [PMID: 32706953]
[http://dx.doi.org/10.1016/j.phrs.2017.07.013] [PMID: 28712971]
[http://dx.doi.org/10.1038/s41422-020-0282-0] [PMID: 32020029]
[http://dx.doi.org/10.1186/1475-2875-12-173] [PMID: 23718705]
[http://dx.doi.org/10.1161/CIRCRESAHA.120.317015] [PMID: 32264791]
[http://dx.doi.org/10.1038/s41586-020-2558-4] [PMID: 32698191]
[http://dx.doi.org/10.1016/j.cell.2020.02.052] [PMID: 32142651]
[http://dx.doi.org/10.11477/mf.1416201388] [PMID: 31506398]
[http://dx.doi.org/10.18231/j.jchm.2020.013]
[http://dx.doi.org/10.1371/journal.pone.0126082] [PMID: 25946000]
[http://dx.doi.org/10.1002/hep.27186] [PMID: 24753082]
[http://dx.doi.org/10.1016/j.chom.2016.07.004] [PMID: 27476412]
[http://dx.doi.org/10.1002/14651858.CD010599.pub2] [PMID: 32289194]
[http://dx.doi.org/10.1002/jmv.27122] [PMID: 34076901]
[http://dx.doi.org/10.1183/13993003.03725-2020] [PMID: 33361100]
[http://dx.doi.org/10.1038/s41579-020-00468-6] [PMID: 33116300]
[http://dx.doi.org/10.1016/S2213-2600(20)30354-4] [PMID: 32771081]
[http://dx.doi.org/10.1016/j.cell.2020.03.045] [PMID: 32275855]
[http://dx.doi.org/10.1358/dot.2010.46.6.1459659] [PMID: 20571608]
[http://dx.doi.org/10.1016/j.toxrep.2014.10.019] [PMID: 28962308]
[http://dx.doi.org/10.1073/pnas.1617020114] [PMID: 28003465]
[http://dx.doi.org/10.1021/acscentsci.0c00489] [PMID: 32483554]
[http://dx.doi.org/10.1016/j.jiph.2016.04.001] [PMID: 27095301]
[http://dx.doi.org/10.21873/invivo.11949] [PMID: 32503817]
[http://dx.doi.org/10.1159/000485724] [PMID: 30041229]
[http://dx.doi.org/10.1056/NEJMoa012354] [PMID: 12087139]
[http://dx.doi.org/10.1016/j.ijid.2020.10.069] [PMID: 33130203]
[http://dx.doi.org/10.1007/s10930-020-09921-0] [PMID: 33034824]
[http://dx.doi.org/10.1093/jac/dki209] [PMID: 15994247]
[http://dx.doi.org/10.2165/00003495-200767130-00015] [PMID: 17722965]
[http://dx.doi.org/10.13140/RG.2.2.14844.69767]
[http://dx.doi.org/10.1016/j.ijantimicag.2020.105998] [PMID: 32360231]
[http://dx.doi.org/10.1016/S2213-2600(19)30417-5] [PMID: 32043986]
[http://dx.doi.org/10.1080/14787210.2021.1950532] [PMID: 34225541]
[http://dx.doi.org/10.1007/s00705-021-04956-9] [PMID: 33492523]
[http://dx.doi.org/10.2174/1871526520666200511005546]