Novel insights into the treatment of SARS-CoV-2 infection: An overview of current clinical trials

Int J Biol Macromol. 2020 Dec 15;165(Pt A):18-43. doi: 10.1016/j.ijbiomac.2020.09.204. Epub 2020 Sep 28.

Abstract

The emergence of the global pandemic caused by the novel SARS-CoV-2 virus has motivated scientists to find a definitive treatment or a vaccine against it in the shortest possible time. Current efforts towards this goal remain fruitless without a full understanding of the behavior of the virus and its adaptor proteins. This review provides an overview of the biological properties, functional mechanisms, and molecular components of SARS-CoV-2, along with investigational therapeutic and preventive approaches for this virus. Since the proteolytic cleavage of the S protein is critical for virus penetration into cells, a set of drugs, such as chloroquine, hydroxychloroquine, camostat mesylate have been tested in clinical trials to suppress this event. In addition to angiotensin-converting enzyme 2, the role of CD147 in the viral entrance has also been proposed. Mepolizumab has shown to be effective in blocking the virus's cellular entrance. Antiviral drugs, such as remdesivir, ritonavir, oseltamivir, darunavir, lopinavir, zanamivir, peramivir, and oseltamivir, have also been tested as treatments for COVID-19. Regarding preventive vaccines, the whole virus, vectors, nucleic acids, and structural subunits have been suggested for vaccine development. Mesenchymal stem cells and natural killer cells could also be used against SARS-CoV-2. All the above-mentioned strategies, as well as the role of nanomedicine for the diagnosis and treatment of SARS-CoV-2 infection, have been discussed in this review.

Keywords: COVID-19; Global pandemic; Investigational drugs; SARS-CoV-2; Vaccine development; Virus mechanism.

Publication types

  • Review

MeSH terms

  • Antiviral Agents / therapeutic use
  • COVID-19 / immunology
  • COVID-19 / therapy*
  • COVID-19 Drug Treatment
  • Clinical Trials as Topic*
  • Humans
  • SARS-CoV-2 / drug effects
  • SARS-CoV-2 / immunology
  • SARS-CoV-2 / physiology
  • Viral Vaccines / immunology

Substances

  • Antiviral Agents
  • Viral Vaccines