The novel coronavirus pandemic has posed unprecedented challenges to health systems worldwide. As the virus continues to spread, researchers have been racing against time to find effective treatments. While a vaccine is still being developed, some treatment options are emerging that show promise. This article provides an overview of the current status of drugs being tested and utilized for coronavirus treatment.

Remdesivir

One of the front-runners is the antiviral drug remdesivir, originally developed by Gilead Sciences to treat Ebola. Remdesivir works by interfering with the virus’ ability to replicate itself. Clinical trials in both China and the US have found that remdesivir may help reduce recovery time for hospitalized COVID-19 patients. In late April, the US Food and Drug Administration approved remdesivir for emergency use to treat severe Coronavirus Treatment Drugs cases. According to studies, remdesivir can significantly shorten recovery time from 15 days to 11 days on average when given to hospitalized patients. However, its effectiveness in preventing deaths is still being studied. More evidence is still needed from ongoing clinical trials to establish its long term safety and efficacy.

Hydroxychloroquine and Chloroquine

Despite some early encouraging results, the antimalarial drugs hydroxychloroquine and chloroquine have faced controversy over their effectiveness. Studies published in March found hydroxychloroquine improved clearance of the virus from the body when used early in the disease process in combination with the antibiotic azithromycin. However, recent larger controlled clinical trials found these drugs were not significantly better than standard care alone. Some studies also suggested these drugs could have safety risks including cardiac side effects when used for COVID-19 treatment. Their use for COVID-19 remains uncertain until more conclusive evidence is available.

Convalescent Plasma Therapy

Convalescent plasma therapy uses antibodies from the blood of recovered COVID-19 patients to treat those still battling the infection. The concept relies on the transfer of passive immunity to a new patient using antibodies against the virus. Some preliminary studies have shown promise but larger controlled trials are still underway. Challenges include availability of donor plasma and determining optimum dosage and timing of administration. Plasma therapy is considered reasonably safe but carries theoretical risks like transmission of other pathogens. More research is still needed to prove its efficacy compared to standard care.

Monoclonal Antibody Therapies

Monoclonal antibodies mimic the immune system's natural antibodies and can be targeted to specific proteins of the SARS-CoV-2 virus. Several companies are working on monoclonal antibody therapies against key viral targets like the spike protein. Advantages include consistency and potentially longer duration of effect compared to convalescent plasma. Some leading projects in clinical testing include Lilly's monoclonal antibody treatment LY-CoV555 and Regeneron'sREGN-COV2 cocktail. So far, results from early trials are promising but larger studies are still ongoing to prove safety and effectiveness for treating and preventing COVID-19. If successful, monoclonal antibody therapies may become available by early 2021.

Other Promising Drugs

In addition to the above, some repurposed arthritis and inflammation drugs are also being studied for their potential in modulating the cytokine storm associated with severe COVID-19. Drugs like Roche's Actemra (tocilizumab), Sanofi and Regeneron's Kevzara (sarilumab), and Eli Lilly's Olumiant (baricitinib) target specific cytokines implicated in lung injuries. Preliminary results seem to indicate these medications may help reduce ventilation time but more clinical evidence is still needed to validate their benefit over standard care. Other therapeutic approaches in clinical testing phases include drugs inhibiting clotting, platelet aggregation, and acute respiratory distress.

Vaccines Provide Long Term Solution

While drugs can help patients recover faster or prevent worsening, vaccines provide the best hope for ending the pandemic by achieving herd immunity at the population level. Leading vaccine candidates in late stage trials include Moderna's mRNA-1273, Oxford-AstraZeneca's viral vector vaccine, Pfizer-BioNTech's BNT162, and Johnson & Johnson's adenovirus vector vaccine. Two or three doses are being tested to check for safety, ability to generate protective antibodies and long term immunity. If at least one vaccine proves effective in large trials, approvals may start by early to mid 2021, allowing distribution to high risk groups and frontline workers first. Vaccines combined with continued therapeutic options and ongoing surveillance are key to controlling COVID-19 in the long term.

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