Infectious Diseases

Treatments for Coronavirus: Identifying Currently Available Drugs That Can Combat COVID-19

Posted on 4 March 2020

Coronavirus is spreading fast all over the world. As of this writing, there are over 95,000 reported cases, more than 3,500 people have died, and 70 countries have been affected by this virus (click to see the latest numbers). Prof. Marc Lipsitch, Professor of Epidemiology at Harvard University, estimates that 40 to 70% of the world’s adults will get infected by the coronavirus. For most people coronavirus infection will be just like having the seasonal flu, a bit annoying but not life-threatening. But people with heart disease, or type 2 diabetes, or long-term smokers, and/or the elderly are in the high-risk group, and may suffer complications.

To help ease your worries about coronavirus we have put together a list of medicines that are currently available, and are known to help treat coronavirus infections. These medicines are currently undergoing rapid clinical trials (listed below) to understand their range of effectiveness for treating coronavirus infections, and to ascertain their limitations.

Unlike bacteria, viruses cannot divide and multiply independently, but instead rely on the replication machinery of the host’s cells. Antiviral drugs combat viral infections, not by destroying the virus, but rather by interfering with its ability to replicate, for example by blocking its entry into the host cell. With the continued spread of COVID-19, efforts are underway to find existing antiviral drugs that can tackle the disease. Here is a short list of the current most effective ones.

Remdesivir

Remdesivir was first developed to treat Ebola virus, but has since been found to be effective against other viruses, including coronaviruses. The drug is similar in structure to core components of RNA and DNA, and interferes with the replication of viral genetic material.

Two clinical trials of remdesivir are taking place in China, one in severely ill patients, and another in patients who are hospitalised but not severely ill. As the drug has had activity against every coronavirus tested so far, remdesivir currently looks to be a promising potential treatment.

Favipiravir

Favipiravir, also known as Avigan, works similarly to Remdesivir, is effective against a variety of viruses, and is approved for the treatment of influenza. It has now been approved in China as an experimental treatment for coronavirus, having shown efficacy in a trial of 70 patients.

Chloroquine

A drug primarily used to treat and prevent malaria, Chloroquine has also been found to have antiviral effects. It is available as a generic medication, but can have serious side effects such as muscle damage and seizures. Preliminary results from clinical trials in China have reported that chloroquine is effective at treating COVID-19-induced pneumonia in over 100 patients, shortening the course of the disease. Reassuringly, no severe adverse reactions to the drug were noted.

On 15 February, a conference of experts in China agreed Chloroquine was effective against COVID-19, recommending 500mg a day for 10 days to treat mild to severe cases of coronavirus pneumonia. Chloroquine is available in most UK pharmacies for malaria prevention under pharmacist supervision.

Antiretroviral Drugs

Retroviruses such as HIV replicate by incorporating their genetic material into the DNA of the host cell. During the replication process, enzymes called proteases are used to cut the proteins that will form new viral particles.

Drugs that inhibit these proteases are used to treat HIV, but have also shown effectiveness against COVID-19. While coronaviruses are not retroviruses, it appears that proteases play a similarly important role in their life-cycle and represent an effective target. A clinical trial is underway in China to test the effectiveness of a combination of these drugs.

These are just some of the few drugs that aid in the treatment of coronavirus infections. Over the next few months and years many companies, and governments are developing several vaccines, gene therapies, and novel drugs to tackle and cure coronavirus infections. A comprehensive list of all drugs, and vaccines under development can be found at the Clinical Trial Arena.


References

Severe 2019-nCoV Remdesivir RCT: https://clinicaltrials.gov/ct2/show/NCT04257656

Mild/Moderate 2019-nCoV Remdesivir RCT: https://clinicaltrials.gov/ct2/show/NCT04252664?term=remdesivir&draw=2

Coronavirus treatment: Vaccines/drugs in the pipeline for Covid-19: https://www.clinicaltrialsarena.com/analysis/coronavirus-mers-cov-drugs/

Therapeutic options for the 2019 novel coronavirus (2019-nCoV): doi: 10.1038/d41573-020-00016-0

Breakthrough: Chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies: https://doi.org/10.5582/bst.2020.01047

[Expert consensus on chloroquine phosphate for the treatment of novel coronavirus pneumonia].: https://www.ncbi.nlm.nih.gov/pubmed/32075365/

The Efficacy of Lopinavir Plus Ritonavir and Arbidol Against Novel Coronavirus Infection (ELACOI): https://clinicaltrials.gov/ct2/show/NCT04252885

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