Hareem Arif Khattak

4^th year MBBS, Islamabad Medical & Dental College, Islamabad Pakistan

Key Points

• Antiviral such as interferon α (IFN-α), lopinavir/ritonavir, chloroquine phosphate, ribavirin and arbidol are now incorporated in the guidelines for provisional cure of the novel corona virus disease.

Sars Cov 2 has been a worldwide pandemic originally reporting its initial cases in China, Japan and South Korea since December’19. Numerous agents have undergone trials by scientists, internationally, to discover suitable antivirals for treating the virus, mainly, chloroquine, arbidol, remdesivir and favipiravir. Their safety and efficacy have been tested with some promising results¹. Until now, the effectiveness of some of the above mentioned, medicinal agents will be enlisted in this piece of scientific writing.
Extensive studies have also revealed Western medication, natural products, traditional Chinese medicine to be useful in the treatment of Sars cov 2.
Antivirals such as interferon α (IFN-α), lopinavir/ritonavir, chloroquine phosphate, ribavirin and arbidol are now incorporated in the present-day report of the guidelines for the hindrance, identification and handling of covid induced pneumonia issued by National Health Commission (NHC) of the People’s Republic of China for provisional cure of the Novel corona virus disease².
Interferon α (IFN-α) has far-ranging effects as an anti-viral drug while treating hepatitis, it is also known to hamper Sars cov replication outside living organisms. Lopinavir or ritonavir is used for treatment of HIV-1 strain in combination with other drugs for such patients, Chu et al also found out that these two have immense efficacy against Sars cov outside living ogranisms and their environments as well as clinical trials. Nucleoside antiviral drugs like Ribavirin are also considered to treat a wide scope of patients. Patients treated with combined therapy of above-mentioned drugs have a lesser probability of acute respiratory distress syndrome. A popular, routinely used anti-malarial drug is Chloroquine which chokes Sars-cov-2 reproduction at lesser micro molar quantifiable values. Arbidol is effective during treatment of influenza virus which has also been reported to block Cov-2 (sars) replication at minute concentration levels ranging from 9-29 micro molar.
Apart from the mentioned drugs in the recommended guidelines, favipiravir warrants attention due to being an RNA polymerase inhibitor which is also being investigated clinically for the treatment of covid. It is used to inhibit reproduction of a massive variety of RNA viruses like bunya, filo, arena, noro etc. It has been indicated to have lesser hazardous side effects than lopinavir or ritonavir and also proves to be more useful than them. Remdesivir antiviral drug has also emerged as a convenient agent for treatment of Covid-19 being a nucleoside analogue. Clinical trials have also shown a certain variety of other drugs which may have prospective usefulness during treatment of COVID-19 for example darunavir, a second-generation HIV-1 protease inhibitor. Additional budding medications contain type II transmembrane serine protease inhibitors along with BCR-ABL kinase inhibitor imatinib. Hoffmann et al. specified the use of SARS Cov receptor by Sar cov 2, Ace-2 receptor and cellular protease TMPRSS2 to gain entry into specific target cells. TMPRSS2 blockers impede the entire process which makes it a potent class of drugs under speculation. Anticoronal action of Imatinib hinders virions-endosomal membrane combination. A combined investigation group of Shanghai Institute of Materia Medica and Shanghai Tech University executed screening of drugs using silicon and enzyme activity trial, around 30 representative drugs had prospective antiviral action in the treatment of Sars cov 2, dated 25 Jan’20. They included tipranavir, fosamprenavir, lopinavir, tideglusib, carfilzomib, ritonavir, remdesivir, darunavir, tipranavir, fosamprenavir, enzaplatovir, indinavir, presatovirbortezomib, elvitegravir, maribavir, PX- 12, montelukast, deoxyrhapontin, polydatin, raltegravir, chalcone, disulfiram, carmofur, abacavir, shikonin, ebselen, atazanavir, TDZD-8, cyclosporin A along with cinanserin.
A similiar research also discovered Chinese herbal medications like Rhizoma Polygoni Cuspidati and Radix Sophorae. Siam Benzoin gum, also called Tonkinensis comprises of potent elements that can combat Sars cov 2³. While the virus spreads like wild-fire worldwide, experts from almost all corners of the world are dynamically bringing into light different drugs which will be of utmost benefit while treating people suffering from the disease. Up until now, there aren’t any substantial, experimentally proven antivirals particular to the cure of covid-19. Effectiveness and decreased incidence of adverse effects of the aforementioned contender drugs during the management of covid-19 should be verified during additional clinic-based investigations and studies.

References

Volume 2
2020

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An Official Publication of Student Spectrum at
Islamabad Medical & Dental College

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Address of Correspondence

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Hareem Arif Khattak
4 ^th Year MBBS
Islamabad Medical and Dental College