Therapy of COVID-19: vaccines and drugs

Abstract

The COVID-19 pandemic, caused by SARS-CoV-2 - a novel and highly infectious coronavirus, has been spreading around the world for over a year, and poses a serious threat to the public health. Numerous studies have revealed the genome, structure and replication cycle of the SARS-CoV-2 virus as well as the immune response to infection. Data from these studies provide a firm basis for the development of strategies to prevent the further spread of COVID-19, as well as to synthesize effective and safe vaccines and drugs. First and foremost, vaccines are needed to control the COVID-19 pandemic. According to data released by WHO, at the beginning of 2021 there were 63 potential vaccines under clinical examinations, and over 172 in preclinical trials. The most promising vaccines are mRNA-based: Comirnaty (Pfizer- BioNTech), COVID-19 Vaccine (Moderna/NIAID) and CVnCoV (CureVac);vector vaccines: COVID-19 Vaccine (AstraZeneca/Oxford University), Gam-COVIDVac (Gamaleja Institute, Russia) and JNJ-78436735/Ad.26.COV2.S. (Johnson & Johnson), and NVX-CoV2373 recombinant subunit vaccine (Novavax). The following groups of drugs potentially may be used in the COVID-19 therapy: Antiviral drugs with different mechanisms of action - blocking the binding of SARS-CoV-2 to its specific receptor on cell membrane (angiotensin coverting enzyme 2;ACE2) and inhibiting viral entry into host cells (umifenovir, chloroquine, hydroxychloroquine, camostat mesylate and nafamostat);drugs that inhibit viral replication (inhibitors of RNA-dependent RNA polymerase, e.g. remdesivir, favipiravir, ribovirin and molnupiravir;protease inhibitors, e.g. Kaletra);immunomodulating drugs (humanized monoclonal anticytokine antibodies, e.g. adalimumab, infliximab, tocilizumab and anakinra;JAK kinase inhibitors - ruxolitinib and baricitinib), anti-inflammatory drugs (glucocorticosteroids), and neutralizing monoclonal antibodies targeting the SARS-CoV-2 spike protein (S). Moreover, low molecular weight heparin is used for prophylactic and therapeutic purposes. © 2021 Polish Pharmaceutical Society. All rights reserved.