Summary
Repurposing of existing antiviral drugs, immunological modulators, and
supportive therapies represents a promising path toward rapidly
developing new control strategies to mitigate the devastating public
health consequences of the COVID-19 pandemic. A comprehensive
text-mining and manual curation approach was used to comb and summarize
the most pertinent information from existing clinical trials and
previous efforts to develop therapies against related betacoronaviruses,
particularly SARS and MERS. In contrast to drugs in current trials,
which have been derived overwhelmingly from studies on unrelated RNA
viruses, a number of untested small molecule antivirals had previously
demonstrated remarkable in vitro specificity for SARS-CoV or
MERS-CoV, with high selectivity indices, EC50, and/or
IC50. Due to the containment of the prior epidemics,
however, these were largely not followed up with animal studies or
clinical investigations and thus overlooked as treatment prospects in
the current COVID-19 trials. This brief review summarizes and tabulates
core information on the dozens of clinical trials currently in progress,
while detailing the most promising untested candidates with prior
documented success against the etiologic agents of SARS and/or MERS.
Keywords: COVID-19, drug repositioning, pandemics, antiviral
agents, data mining, SARS