• Logo
  • SBMUJournals

Review of therapeutic agents for the treatment of COVID-19

Shadi Ziaie, Mehran Koucheck, MirMohammad Miri, Sara Salarian, Seyedpouzhia Shojaei, Mehrdad Haghighi, Mohammad Sistanizad




In late December 2019, a cluster of unexplained pneumonia cases has been reported in Wuhan, China, named coronavirus disease 2019 (COVID -19) which has been spreading in 204 countries. In this review, the mains pharmaceutical option quoted previously and especially available for ICU patients are reviewed.


COVID-19, Pharmacotherapy, Antiviral, Immunomodulators


Coronavirus disease (COVID-19) Pandemic 2020 [updated March 31; cited 2020 March 31]. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019.

Landscape analysis of therapeutics 2020 [updated March 21; cited 2020 March 31]. Available from: https://www.who.int/blueprint/priority-diseases/key-action/Table_of_therapeutics_Appendix_17022020.pdf?ua=1.

Request for Emergency Use Authorization For Use of Chloroquine Phosphate or Hydroxychloroquine Sulfate Supplied From the Strategic National Stockpile for Treatment of 2019 Coronavirus Disease 2020 [updated March 28, 2020; cited 2020 March 31]. Available from: https://www.fda.gov/media/136534/download.

INTERIM CLINICAL GUIDANCE FOR PATIENTS SUSPECTED OF/CONFIRMED WITH COVID-19 IN BELGIUM 2020 [updated March 24, 2020; cited 2020 31 March]. Available from: https://epidemio.wiv-isp.be/ID/Documents/Covid19/COVID-19_InterimGuidelines_Treatment_ENG.pdf.

Cennimo DJ. Coronavirus Disease 2019 (COVID-19) Treatment & Management: MedScape; 2020 [updated March 30, 2020; cited 2020 March 31]. Available from: https://emedicine.medscape.com/article/2500114-treatment.

Liu J, Cao R, Xu M, Wang X, Zhang H, Hu H, et al. Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitro. Cell Discov. 2020 Mar 18;6:16.

Keyaerts E, Vijgen L, Maes P, Neyts J, Van Ranst M. In vitro inhibition of severe acute respiratory syndrome coronavirus by chloroquine. Biochem Biophys Res Commun. 2004;323(1):264-8.

Vincent MJ, Bergeron E, Benjannet S, Erickson BR, Rollin PE, Ksiazek TG, et al. Chloroquine is a potent inhibitor of SARS coronavirus infection and spread. Virol J. 2005;2:69.

Ooi EE, Chew JS, Loh JP, Chua RC. In vitro inhibition of human influenza A virus replication by chloroquine. Virol J. 2006;3:39.

Fox RI. Mechanism of action of hydroxychloroquine as an antirheumatic drug. Semin Arthritis Rheum. 1993;23(2 Suppl 1):82-91.

Tsai WP, Nara PL, Kung HF, Oroszlan S. Inhibition of human immunodeficiency virus infectivity by chloroquine. AIDS Res Hum Retroviruses. 1990;6(4):481-9.

Farias KJ, Machado PR, da Fonseca BA. Chloroquine inhibits dengue virus type 2 replication in Vero cells but not in C6/36 cells. ScientificWorldJournal. 2013;2013:282734.

Zhu YZ, Xu QQ, Wu DG, Ren H, Zhao P, Lao WG, et al. Japanese encephalitis virus enters rat neuroblastoma cells via a pH-dependent, dynamin and caveola-mediated endocytosis pathway. J Virol. 2012;86(24):13407-22.

Boonyasuppayakorn S, Reichert ED, Manzano M, Nagarajan K, Padmanabhan R. Amodiaquine, an antimalarial drug, inhibits dengue virus type 2 replication and infectivity. Antiviral Res. 2014;106:125-34.

Savarino A, Boelaert JR, Cassone A, Majori G, Cauda R. Effects of chloroquine on viral infections: an old drug against today's diseases? Lancet Infect Dis. 2003;3(11):722-7.

oseltamivir (Rx): MedScape; 2020 [cited 2020 April 1]. Available from: https://reference.medscape.com/drug/tamiflu-oseltamivir-342618#10.

Paul G. Auwaerter. Coronavirus COVID-19 (SARS-CoV-2): JOHNS HOPKINS medicine; 2020 [updated March 30, 2020; cited 2020 April 1]. Available from: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540747/all/Coronavirus_COVID_19__SARS_CoV_2.

Assessment of Evidence for COVID-19-Related Treatments: ASHP pharmacists advancing healthcare; 2020 [updated March 31; cited 2020 April 1]. Available from: https://www.ashp.org/-/media/assets/pharmacy-practice/resource-centers/Coronavirus/docs/ASHP-COVID-19-Evidence-Table.ashx?la=en&hash=B414CC64FD64E1AE8CA47AD753BA744EDF4FFB8C.

Lu H. Drug treatment options for the 2019-new coronavirus (2019-nCoV). Biosci Trends. 2020;14(1):69-71.

Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-13.

lopinavir/ritonavir (Rx) 2020 [cited 2020 April 1]. Available from: https://reference.medscape.com/drug/kaletra-lopinavir-ritonavir-342629#10.

Cao B, Wang Y, Wen D, Liu W, Wang J, Fan G, et al. A Trial of Lopinavir–Ritonavir in Adults Hospitalized with Severe Covid-19. N Engl J Med. 2020 Mar 18.

Alhazzani W, Moller MH, Arabi YM, Loeb M, Gong MN, Fan E, et al. Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19). Intensive Care Med. 2020 Mar 28.

ribavirin (Rx): MedScape; [Available from: https://reference.medscape.com/drug/rebetol-ribasphere-ribavirin-342625#10.

Bryan T. Alexander P, Trevor Van Schooneveld M, Erica Stohs M, Jasmine Marcelin M, Scott Bergman P, Richard Hankins M. COVID-19 Antiviral and Pharmacotherapy Recommendations. In: Medicine N, editor. Nebraska Medicine2020.

Tchesnokov EP, Feng JY, Porter DP, Gotte M. Mechanism of Inhibition of Ebola Virus RNA-Dependent RNA Polymerase by Remdesivir. Viruses. 2019;11(4).

Warren TK, Jordan R, Lo MK, Ray AS, Mackman RL, Soloveva V, et al. Therapeutic efficacy of the small molecule GS-5734 against Ebola virus in rhesus monkeys. Nature. 2016;531(7594):381-5.

Study to evaluate the safety and antiviral activity of remdesivir (GS-5734) in participants with severe coronavirus disease (COVID-19) 2020 [Available from: www.clinicaltrials.gov/ct2/show/NCT04292899.

Dong L, Hu S, Gao J. Discovering drugs to treat coronavirus disease 2019 (COVID-19). Drug Discov Ther. 2020;14(1):58-60.

Furuta Y, Takahashi K, Shiraki K, Sakamoto K, Smee DF, Barnard DL, et al. T-705 (favipiravir) and related compounds: Novel broad-spectrum inhibitors of RNA viral infections. Antiviral Res. 2009;82(3):95-102.

Zaraket H, Saito R. Japanese Surveillance Systems and Treatment for Influenza. Curr Treat Options Infect Dis. 2016;8(4):311-28.

Jochmans D, van Nieuwkoop S, Smits SL, Neyts J, Fouchier RA, van den Hoogen BG. Antiviral Activity of Favipiravir (T-705) against a Broad Range of Paramyxoviruses In Vitro and against Human Metapneumovirus in Hamsters. Antimicrob Agents Chemother. 2016;60(8):4620-9.

Clinical Trial of Favipiravir Tablets Combine With Chloroquine Phosphate in the Treatment of Novel Coronavirus Pneumonia [Available from: https://clinicaltrials.gov/ct2/show/NCT04319900.

Various Combination of Protease Inhibitors, Oseltamivir, Favipiravir, and Hydroxychloroquine for Treatment of COVID19 : A Randomized Control Trial (THDMS-COVID19) [Available from: https://clinicaltrials.gov/ct2/show/NCT04303299.

Favipiravir Combined With Tocilizumab in the Treatment of Corona Virus Disease 2019 [Available from: https://clinicaltrials.gov/ct2/show/NCT04310228.

Li X, Geng M, Peng Y, Meng L, Lu S. Molecular immune pathogenesis and diagnosis of COVID-19.

J Pharm Anal. 2020;In press.

Kasper LH, Reder AT. Immunomodulatory activity of interferon-beta. Ann Clin Transl Neurol. 2014;1(8):622-31.

Sheahan TP, Sims AC, Leist SR, Schäfer A, Won J, Brown AJ, et al. Comparative therapeutic efficacy of remdesivir and combination lopinavir, ritonavir, and interferon beta against MERS-CoV. Nat Commun. 2020;11(1):222.

Zhang L, Liu Y. Potential interventions for novel coronavirus in China: A systematic review. J Med Virol. 2020;92(5):479-90.

Joseph T, Moslehi MA. INTERNATIONAL PULMONOLOGIST’S CONSENSUS ON COVID-19 2020 [cited 2020 April 1]. Available from: https://www.unah.edu.hn/dmsdocument/9674-consenso-internacional-de-neumologos-sobre-covid-19-version-ingles.

Ranieri VM, Pettilä V, Karvonen MK, Jalkanen J, Nightingale P, Brealey D, et al. Effect of Intravenous Interferon β-1a on Death and Days Free From Mechanical Ventilation Among Patients With Moderate to Severe Acute Respiratory Distress Syndrome: A Randomized Clinical Trial. JAMA. 2020.

COVID-19 Treatment Guidance Department of Medicine, Massachusetts General Hospital2020 [cited 2020 April 1]. Available from: https://www.massgeneral.org/news/coronavirus/treatment-guidances.

Murthy H, Iqbal M, Chavez JC, Kharfan-Dabaja MA. Cytokine Release Syndrome: Current Perspectives. Immunotargets Ther. 2019;8:43-52.

McIntosh K. Coronavirus disease 2019 (COVID-19): UpToDate; 2020 [updated March 31; cited 2020 April 1]. Available from: https://www.uptodate.com/contents/coronavirus-disease-2019-covid-19.

Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 2020;395(10229):1033-4.

Unproven Therapies for COVID-19 British Colombia center British Colombia center 2020 [updated March 24. Available from: http://www.bccdc.ca/Health-Professionals-Site/Documents/Guidelines_Unproven_Therapies_COVID-19.pdf.

McCreary EK, Pogue JM. COVID-19 Treatment: A Review of Early and Emerging Options. Open Forum Infect Dis. 2020.

Cao W, Liu X, Bai T, Fan H, Hong K, Song H, et al. High-Dose Intravenous Immunoglobulin as a Therapeutic Option for Deteriorating Patients With Coronavirus Disease 2019. Open Forum Infect Dis. 2020;7(3): 1-6.

Hartung HP. Advances in the understanding of the mechanism of action of IVIg. J Neurol. 2008;255 Suppl 3:3-6.

Hu H, Ma F, Wei X, Fang Y. Coronavirus fulminantmyocarditis treated with glucocorticoid and human immunoglobulin. Eur Heart J. 2020 Mar 16. pii: ehaa190.

DOI: https://doi.org/10.22037/jcma.v5i1.29760


  • There are currently no refbacks.