Edicin especial COVID-19 Abril-Diciembre 2020 82
ISSN 1317-987X
 
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Tratamiento COVID-19
COVID-19 update: The race to therapeutic development
Fecha de recepción: 15/09/2020
Fecha de aceptación:
20/10/2020




Abstract

The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), represents an unprecedented challenge to global public health. At the time of this review, COVID-19 has been diagnosed in over 40 million cases and associated with 1.1 million deaths worldwide. Current management strategies for COVID-19 are largely supportive, and while there are more than 2000 interventional clinical trials registered with the U.S. National Library of Medicine (clinicaltrials.gov), results that can clarify benefits and risks of candidate therapies are only gradually becoming available. We herein describe recent advances in understanding SARS-CoV-2 pathobiology and potential therapeutic targets that are involved in viral entry into host cells, viral spread in the body, and the subsequent COVID-19 progression. We highlight two major lines of therapeutic strategies for COVID-19 treatment: 1) repurposing the existing drugs for use in COVID-19 patients, such as antiviral medications (e.g., remdesivir) and immunomodulators (e.g., dexamethasone) which were previously approved for other disease conditions, and 2) novel biological products that are designed to target specific molecules that are involved in SARS-CoV-2 viral entry, including neutralizing antibodies against the spike protein of SARS-CoV-2, such as REGN-COV2 (an antibody cocktail), as well as recombinant human soluble ACE2 protein to counteract SARS-CoV-2 binding to the transmembrane ACE2 receptor in target cells. Finally, we discuss potential drug resistance mechanisms and provide thoughts regarding clinical trial design to address the diversity in COVID-19 clinical manifestation. Of note, preventive vaccines, cell and gene therapies are not within the scope of the current review.



Key Word
COVID-19 SARS-CoV-2 Virus life cycle Therapeutic targets Drug development Antivirals Immunomodulators Monoclonal antibodies ACE2 Spike protein Repurposed use Existing drugs

COVID-19 update: The race to therapeutic development

Julianne D. Twomey1, Shen Luo1, Alexis Q. Dean1, William P. Bozza1, Ancy Nalli1, Baolin Zhang1,*

Office of Biotechnology Products, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD 20993, United States

* Corresponding author. E-mail address: Baolin.zhang@fda.hhs.gov (B. Zhang)

1All authors contributed equally and agreed to the content of the manuscript.

Drug Resistance Updates 53 (2020) 100733


Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, thecompany's public news and information website. 

Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.





COVID-19 update: The race to therapeutic development

NOTA: Toda la informacin que se brinda en este artculo es de carcter investigativo y con fines acadmicos y de actualizacin para estudiantes y profesionales de la salud. En ningn caso es de carcter general ni sustituye el asesoramiento de un mdico. Ante cualquier duda que pueda tener sobre su estado de salud, consulte con su mdico o especialista.





Instituto de Medicina Tropical - Facultad de Medicina - Universidad Central de Venezuela.
Elaborado por el Centro de Análisis de Imágenes Biomédicas Computarizadas CAIBCO,
caibco@ucv.ve
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