COVID-19: A Review of Clinical Trials and Repurposed Drugs

Abstract

This review was undertaken to synthesize data from various databases on therapeutic clinical trials conducted on COVID- 19 in order to find out the trial details and outcome of the completed trials as well as the rationale for selecting the different trial drugs. The data were obtained from articles published December 2019 to September 4, 2020. The analysis of the data has shown that Corona Virus Disease-19 (COVID-19) is the only disease for which more than 2100 clinical trials have been registered. In these trials many existing drugs like Hydroxychloroquine (HCQ), Remdesivir, Tocilizumab, Sarilumab, Lopinavir/Ritonavir, Favipiravir, Glucocorticoids, COVID-19 convalescent plasma, Mesenchymal stem cells, Interferons, Azithromycin, Ivermectin, traditional medicines and many others are being tested globally for their efficacy in COVID-19. 225 trials have been completed as of September 4, 2020 and the results are available only for a few trials. Out of these results, two have shown favorable outcome for Favipiravir, one for HCQ alone, and one for HCQ + Azithromycin and one for Meplazumab. Topline data of two trials have resulted in the emergency use authorization (EUA) for Remdesivir on May 1, 2020. The available results of NIAD, WHO’s SOLIDARITY, Gilead and RECOVERY trials have not shown the anticipated outcome. The results of the rest of the completed trials are awaited to draw conclusion regarding the definite therapy of COVID-19. The new drug development for COVID-19 is still in its preliminary stage. Identification of potential drug candidates which could selectively inhibit Severe Acute Respiratory Syndrome-Corona Virus 2 (SARS-CoV2) protease (Mpro) and SARS CoV2 S protein is in progress.