218-Article Text-349-1-10-20200401 PDF

Journal of Medical Biomedical and Applied Sciences
J Med Biomed App Sci 8 (4), 358–360 (2020) ISSN (O) 2349-0748
COVID-19: Investigational Drugs

M. Prashanthi Evangelin1 , B. Gopi Krishna2 , S. Yashita Raga3 , SVS. Gopi Raju4 ,
G. Radhika5 , G. Krishna Vamsi6
1 Department of Chemistry, Southern Institute of Medical Sciences
2 Department of Pharmacy, Southern Institute of Medical Sciences
DOI: 10.15520/jmbas.v8i4.218
Accepted 28 March 2020; Received 20 March 2020; Publish Online 1 April 2020
Reviewed By: Dr. ABSTRACT

Daniel V. Coronavirus is a new virus responsible for an outbreak of severe respiratory illness
among humans.This is a zoonotic pathogen which was appeared first in Saudi Arabia
and Jordan. According to WHO report, 858 deaths out of 27 countries were reported
Between April 2012 and December 2019. In the development of viral drugs, the best
target is proteases having specificity and plays an important role in the processing of
viral poly protein. If proper measures were not taken about 90% of worlds population
get infected and 40.6 million would have been killed. So, this present review is focused
on the investigation of drugs.
Key words: Covid–Anti viral–SARS
1 INTRODUCTION
Till date COVID-19 has no drugs either for the prevention
or treatment. Discovering new drugs or therapeutic switch-
ing of an existing drug is a complicated and time-consuming
process. Certain drug categories have been proposed for the
effective treatment of COVID-19 includes antiviral agents,
immunotherapies, and vaccines.332 high-confidence SARS-
CoV-2 human protein-protein interactions are identified by
Gordon et al. Out of these high number of proteins, only 66
human proteins are targeted by 69 existing FDA-approved
drugs, drugs in clinical trials, and/or preclinical compounds.
Up to date research is going on in order to find out the ef-
ficacy of the drugs in SARS-CoV-2 infection. [1]
Figure 1. Structure of Remdesivir

1.1 Antiviral Agents
A nucleotide analog namely remdesivir inFigure 1 (GS-5734;
Gilead Sciences, Inc)which is a prodrug and have been cat-
egorised as a broad spectrum anti-viral agent. This drug in 2003 and Middle East respiratory syndrome coronavirus
was developed for the treatment of Ebola virus and Mar- (MERS-CoV) in 2012 but also its inhibition capacity has
burg virus. Anti-viral activity of this drug can also used gained access to treat corona. [3]
against corona though not proved as it requires more clini- Lopinavir/ritonavir
cal data. [2] Marmosets and mice infected with MERS-CoV showed
Remdesivir is not only used to inhibit the replication of an improvement in clinical parameters by using a regimen
severe acute respiratory syndrome coronavirus (SARS-CoV) of lopinavir/ritonavirFigure 2 with IFNb2
COVID-19: Investigational Drugs 359
A study in France revealed that patients positive to

SARS- CoV-2 are concomitantly suffering from bacte-
rial superinfectionwere exposed to treatment including
azithromycinFigure 4 in 6 patients. Patients who have un-
dergone this treatment had a complete clearance of SARS-
CoV-2. These results must undergo further analysis. Pa-
tients taking combination therapy had lower viral load as
compared to patients taking hydroxychloroquine alone. [6].
Figure 2. Structure of Lopinavir/ritonavir
Adult patients (n= 199) with positive SARS- CoV-

2 infection are subjected to randomized, controlled clin-
ical trials whose oxygen saturation should be of 94% or Figure 4. Structure of Azithromycin
less/ PaO2 of less than 300 mm Hg and were receiving a
range of ventilatory support modes (eg, no support, me- Nitric oxide
chanical ventilation, extracorporeal membrane oxygenation Published findings from the 2004 SARS-CoV infection re-
[ECMO]). Patients added to Standard care(n=99) or stan- veals that there is a use in taking inhaled nitric oxide (iNO;
dard care alone (n=100) received. These patients received Mallinckrodt Pharmaceuticals, plc) as a supportive measure
lopinavir/ritonavir 400 mg/100 mg PO BID for 14 days in for treating infection in patients with pulmonary complica-
a randomised fashion. The received groups did not differ in tions. Positive improvement in symptoms like pulmonary
their clinical outcome and shows lesser mortality rate i.e) hypertension, severe hypoxia, and shortened the duration
28 days when compared to standard care. [4] of ventilatory support is seen in patients receiving iNO as
Hydroxychloroquine and chloroquine compared to matched control patients with SARS. [7]
Apart from its anti-malarial activity, these are used to
treat auto immune disorders like SLE, Rheumatoid arthri-
tis by showing its immune modulatory effects. Interest-
ingly, due to the inhibition of heme polymerase, they found 2 CONCLUSION
a place in antiviral infection treatment. These also in- Covid-19 is widely distributed in the areas of middle east
hibits the pH-dependent steps of viral replication due to countries causing sporadic human disease and reminded in
the alkalinisation of the phagolysosome. Wang et al re- WHO Blueprint 2020 list of priority. To avoid the further
ported that chloroquine effectively inhibits SARS-CoV-2 in spread and to reduce the deaths all countries should invest
vitro. [5]Hydroxychloroquine depicted inFigure 3 on research activities and vaccine invention.
REFERENCES
[1] Gautret P, Lagier JC, Parola P, Hoang VT, Meddeb L, Mailhe
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trial. International Journal of Antimicrobial Agents;.
[2] Gordon DE, Jang GM, Bouhaddou M, Xu J, Obernier K,
Mera O, et al. Accessed; 2020. Available from: https://www.
biorxiv.org/content/10.1101/2020.03.22.002386v1.
[3] Cao B, Wang Y, Wen D, Liu W, Wang J, Fan G. A Trial
of Lopinavir-Ritonavir in Adults Hospitalized with Severe
Figure 3. Structure of Hydroxychloroquine/chloroquine Covid-19. N Engl J Med. 2020;.
[4] Chen L, Liu P, Gao H, Sun B, Chao D, Wang F, et al. In-
Azithromycin halation of Nitric Oxide in the Treatment of Severe Acute
Journal of Medical Biomedical and Applied Sciences , Vol 8 Iss 4, 358–360 (2020)
360 M. Prashanthi Evangelin et al.
Respiratory Syndrome: A Rescue Trial in Beijing. Clinical

Infectious Diseases. 2004;39(10):1531–1535. Available from:
https://dx.doi.org/10.1086/425357.
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Journal of Medical Biomedical and Applied Sciences , Vol 8 Iss 4, 358–360 (2020)

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Journal of Medical Biomedical and Applied Sciences

COVID-19: Investigational Drugs

Reviewed By: Dr. ABSTRACT

Figure 1. Structure of Remdesivir

A study in France revealed that patients positive to

Figure 2. Structure of Lopinavir/ritonavir

Adult patients (n= 199) with positive SARS- CoV-

Respiratory Syndrome: A Rescue Trial in Beijing. Clinical

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