What Works Against SARS-CoV-2? Results of 19 Anti-Virals Screened In Vitro

Posted on by Jesse Santiano, M.D.

19 drugs were screened by the U.S. Food and Drug Administration. A copy of their preprint report is at bioRxiv. The study has not been peer-reviewed and, therefore, should not guide policy or medical decision making.

Covid-19 has claimed 228 thousand lives and infected at least 3.2 million people worldwide, according to the Johns Hopkins CSSE website. Since the start of the pandemic, many drugs have been tried on thousands of patients, but so far, there are no definite drug recommendations.

The paper screened 19 anti-virals against the SARS-CoV-2, the virus that causes COVID-19.  The screening was done in vitro. In vitro refers to a laboratory evaluation like in a test tube or petri dish in contrast to in vivo, which involves testing done on live organisms.

The 19 antivirals were chosen because of in silicon predictions. In silicon refers to computer simulations and attempts to narrow down the choices for testing drugs. In silico rules out other drugs that will not work, at least theoretically and make drug experiments more time and cost-efficient.

The following are the antivirals screened by the FDA.

  1. Remdesivir
  2. Sofosbuvir
  3. Danoprevir
  4. Pocapavir
  5. Bemcentinib
  6. Chloroquine
  7. Velpatasvir
  8. Ledipasvir
  9. Nelfinavir
  10. Ritonavir
  11. Saquinavir
  12. Indinavir,
  13. Amprenavir
  14. Lopinavir
  15. Raltegravir
  16. Tenofovir
  17. AZT
  18. Chloromethylketone
  19. Favilavir

The advantage of their in vitro test is that it also rules out the drugs that cause harm to the cells tested.

Results:

Their results showed that Remdesivir is effective as a potential drug for Covid-19. Remdesivir has demonstrated effectiveness in laboratory studies against the MERS coronavirus and SARS infection in mouse models. Remdesivir has also shown therapeutic efficacy against nonhuman primate models of the deadly Ebola and Nipah virus infections.

In a study supported by Gilead Sciences, the company that makes Remdesivir, 68% of patients who received Remdesivir on a compassionate use had clinical improvement.[1]

Chloroquine displayed negligible protective effects.

The rest of the other drugs did not work. This study is only a screen, and more studies are needed before definitive recommendations can be made.

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Remdesivir_3D_structure
Remdesivir 3D Structure

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  7. How to Beat a Pandemic Just like in the Movies

  8. Traditional Chinese Medicine as Treatment for COVID-19

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  10. Study: Chinese Herbal Medicine to Prevent Coronavirus Infection

References:

  1. Evaluation of 19 antiviral drugs against SARS-CoV-2 Infection
    Shufeng Liu, Christopher Lien, Prabhuanand Selveraj, Tony Wang
    bioRxiv 2020.04.29.067983; doi: https://doi.org/10.1101/2020.04.29.067983
  2. J. Grein eta al, 2020. Compassionate Use of Remdesivir for Patients with Severe Covid-19. The New England Journal of Medicine. April 10, 2020
    DOI: 10.1056/NEJMoa2007016

Image Credit: Remdesivir By BaptisteGrandGrand – Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=89619215

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