Coronavirus disease 2019 (COVID-19): latest developments in potential treatments

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Kam Lun Hon MBBS, MD, Karen Ka Yan Leung MBBS, MRCPCH, Alexander KC Leung MBBS, FRCPC, FRCP (UK & Irel), FRCPCH, FAAP, Su Yun Qian MD, Vivian PY Chan MPharm, MSc (Clin Pharm), BPharm, BCPPS, BCNSP, Patrick Ip MBBS, FRCPCH (Hon), FRCPCH, Ian CK Wong BPharm (Hons), MSc, PhD, FRCPCH (Hon)

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Many viral respiratory infections can cause severe acute respiratory symptoms leading to mortality and morbidity. In the spring of 2003, the severe acute respiratory syndrome (SARS) outbreak caused by SARS-CoV spread globally. In the summer of 2012, the Middle East respiratory syndrome (MERS) outbreak caused by MERS-CoV occurred in Saudi Arabia. In the winter of 2019, the coronavirus disease 2019 (COVID-19) outbreak caused by a novel coronavirus SARS-CoV- 2 occurred in China which rapidly spread worldwide causing a global pandemic. Up until 27 May 2020, there are 5.5 million confirmed cases of COVID-19 and 347,587 COVID-19 related deaths worldwide, and there has also been an unprecedented increase in socioeconomic and psychosocial issues related to COVID-19. This overview aims to review the current developments in preventive treatments and therapies for COVID-19. The development of vaccines for SARS-CoV-2 is ongoing and various clinical trials are currently underway around the world. It is hoped that existing antivirals including remdesivir and lopinavir-ritonavir might have roles in the treatment of COVID-19, but results from trials thus far have not been promising. COVID-19 causes a mild respiratory disease in the majority of cases, but in some cases, cytokine activation causes sepsis and acute respiratory distress syndrome, leading to morbidity and mortality. Immunomodulatory treatments and biologics are also being actively explored as therapeutics for COVID-19. On the other hand, the use of steroidal and nonsteroidal anti-inflammatory drugs (NSAIDs) has been discouraged based on concerns about their adverse effects. Over the past two decades, coronaviruses have caused major epidemics and outbreaks worldwide, whilst modern medicine has been playing catch-up all along.

Keywords: coronavirus, COVID-19, review, SARS-CoV-2, therapeutics, vaccines.

Citation: Hon KL, Leung KKY, Leung AKC, Qian SY, Chan VPY, Ip P, Wong ICK. Coronavirus disease 2019 (COVID-19): latest developments in potential treatments. Drugs in Context 2020; 9: 2020-4-15. DOI: 10.7573/dic.2020-4-15

Contributions: All authors contributed equally to the preparation of this review. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosure and potential conflicts of interest: The authors declare that they have no conflicts of interest. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at:

Acknowledgements: None.

Funding declaration: There was no funding associated with the preparation of this article.

Copyright: Copyright © 2020 Hon KL, Leung KKY, Leung AKC, Qian SY, Chan VPY, Ip P, Wong ICK. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0 which allows anyone to copy, distribute, and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2020 Hon KL, Leung KKY, Leung AKC, Qian SY, Chan VPY, Ip P, Wong ICK. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0.

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Correspondence: Kam Lun Ellis Hon, Department of Paediatrics and Adolescent Medicine, The Hong Kong Children’s Hospital, Hong Kong SAR, China.

Provenance: invited; externally peer reviewed.

Submitted: 20 April 2020; Peer review comments to author: 4 May 2020; Revised manuscript received: 27 May 2020; Accepted: 28 May 2020; Publication date: 29 June 2020.

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