Therapeutic and Vaccine Options for COVID-19: Status after Six Months of the Disease Outbreak

SLAS Discov. 2021 Mar;26(3):311-329. doi: 10.1177/2472555220979579. Epub 2020 Dec 15.

Abstract

An outbreak of the coronavirus disease 2019 (COVID-19) caused by an infection of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) occurred in Wuhan, China, in December 2019. This new virus belongs to the group of enveloped RNA beta-coronaviruses. Symptoms may differ in various infected persons, but major presentations include dry cough, nasal congestion, shortness of breath, fever, and general malaise. The disease appears to be more severe in patients above the age of 60 years and those with underlying conditions such as diabetes, cancer, cardiovascular diseases, chronic respiratory disease, and hypertension. There is still no approved vaccine against COVID-19, but more than a hundred are at different stages of development. It is known that the development of new drugs takes a relatively long time, so several known and already-approved drugs are being repurposed for the treatment of this disease. In this review, we explore the therapeutic and vaccine options that are available for COVID-19 6 months after its outbreak. Most noteworthy among the therapeutic options are dexamethasone, remdesivir, Avigan (favipiravir) and convalescent plasma.

2019年12月に中国・武漢で、新型重症急性呼吸器症候群コロナウイルス2(severe acute respiratory syndrome coronavirus 2:SARS-CoV-2)の感染症に起因する新型コロナウイルス(coronavirus disease 2019:COVID-19)のアウトブレイクが発生した。この新型ウイルスは、エンベロープ型RNAベータコロナウイルス属に分類される。症状は感染者ごとに異なるが、主として空咳、鼻閉、息切れ、発熱、全身倦怠などを呈する。この疾患は、患者が60歳を過ぎている場合や、糖尿病、癌、心血管疾患、慢性呼吸器病、高血圧などの基礎疾患を有する場合に重症度が高くなるとみられている。新型コロナウイルスに対するワクチンは依然としていずれも未承認であるが、現在100種を超えるワクチンがさまざまな開発段階にある。新薬の開発は相対的に長時間を要することが知られていることから、すでに承認されている既知の複数の薬剤がこの疾患の治療目的で利用されている。本稿では、このアウトブレイクから6ヵ月を経た現時点でCOVID-19に利用できる治療法とワクチンの選択肢を検討する。治療選択肢の中で最も注目に値するものは、デキサメタゾン、レムデシビル、アビガン(ファビピラビル)、および回復期血漿から2つを併用する方法である。

새로운 중증급성호흡기증후군 코로나바이러스2(SARS-CoV-2)의 감염으로 인한 코로나바이러스감염증-19(COVID-19) 발병이 2019년 12월 중국 우한에서 발생하였다. 이 새로운 바이러스는 외피보유 RNA 베타 코로나바이러스 군에 속한다. 감염자마다 증상이 상이할 수 있으나, 주요한 증상 발현에는 마른기침, 코막힘, 호흡곤란, 발열, 전신무력감이 포함된다. 이 질병은 60세 이상의 환자와 당뇨, 암, 심혈관 질환, 만성 호흡기 질환, 고혈압과 같은 기저 질환자들에서 더 중증으로 나타난다. 승인된 COVID-19 백신은 아직 없으나, 100개 이상의 백신이 서로 다른 개발 단계에 있다. 신약 개발은 상대적으로 오랜 시간이 걸리므로, 이 질병의 치료를 위해 이미 알려지거나 승인된 여러 약물을 재창출하고 있다. 이 리뷰논문에서는 COVID-19의 발병 이후 6개월 동안 이용 가능한 치료제와 백신의 선택지에 대해 탐구한다. 가장 주목할 만한 치료제 옵션은 덱사메타손, 렘데시비르, 아비간(favipiravir), 회복기혈장의 이중 병용요법이다.

由新型严重急性呼吸系统综合症冠状病毒2(SARS-CoV-2)感染引起的2019年冠状病毒病(COVID-19)于2019年12月在中国武汉爆发。这种新病毒属于包膜β属的RNA冠状病毒。不同感染者的症状可能有所不同,但其主要症状包括干咳、鼻塞、呼吸急促、发烧和全身不适。该疾病似乎在60岁以上的患者以及患有诸如糖尿病、癌症、心血管疾病、慢性呼吸系统疾病和高血压等潜在疾病的患者中更为严重。目前尚无任何针对COVID-19的疫苗被批准使用,但也有一百多种疫苗正处于不同的开发阶段。众所周知,新药的开发需要相对较长的时间,因此几种已知且已被批准使用的药物被转用于治疗该疾病。在本文中,我们探讨了COVID-19爆发6个月后可被使用的治疗方法和疫苗。在各种治疗方法中,最值得一提的是使用地塞米松、瑞德西韦、法匹拉韦(favipiravir)和恢复期血浆。

Keywords: COVID-19; SARS-CoV-2; drug repurposing; therapeutics; vaccines.

Publication types

  • Review

MeSH terms

  • Adenosine Monophosphate / analogs & derivatives
  • Adenosine Monophosphate / therapeutic use
  • Alanine / analogs & derivatives
  • Alanine / therapeutic use
  • Amides / therapeutic use
  • Antiviral Agents / pharmacology
  • Antiviral Agents / therapeutic use*
  • COVID-19 / prevention & control
  • COVID-19 / therapy*
  • COVID-19 Drug Treatment
  • COVID-19 Serotherapy
  • COVID-19 Vaccines / pharmacology*
  • Dexamethasone / therapeutic use
  • Humans
  • Immunization, Passive
  • Pyrazines / therapeutic use
  • SARS-CoV-2 / chemistry
  • SARS-CoV-2 / drug effects
  • Viral Proteins / metabolism

Substances

  • Amides
  • Antiviral Agents
  • COVID-19 Vaccines
  • Pyrazines
  • Viral Proteins
  • remdesivir
  • Adenosine Monophosphate
  • Dexamethasone
  • favipiravir
  • Alanine