Scoping insight on antiviral drugs against COVID-19

• Main Authors: Ahmed S. Ali, Ibrahim M. Ibrahim, Abdulhadi S. Burzangi, Ragia H. Ghoneim, Hanin S. Aljohani, Hamoud A. Alsamhan, Jehan Barakat
• Format: Article
• Language: English
• Published: Elsevier 2021-10-01
• Series: Arabian Journal of Chemistry
• Subjects: SARS-CoV-2; Pharmacokinetics; Pharmacodynamics; Remdesivir; Lopinavir; Hydroxychloroquine
• Online Access: http://www.sciencedirect.com/science/article/pii/S1878535221004007

Background: COVID-19 is an ongoing viral pandemic produced by SARS-CoV-2. In light of in vitro efficacy, several medications were repurposed for its management. During clinical use, many of these medications produced inconsistent results or had varying limitations. Objective: The purpose of this literature review is to explain the variable efficacy or limitations of Lopinavir/Ritonavir, Remdesivir, Hydroxychloroquine, and Favipiravir in clinical settings. Method: A study of the literature on the pharmacodynamics (PD), pharmacokinetics (PK), safety profile, and clinical trials through academic databases using relevant search terms. Results & discussion: The efficacy of an antiviral drug against COVID-19 is associated with its ability to achieve therapeutic concentration in the lung and intestinal tissues. This efficacy depends on the PK properties, particularly protein binding, volume of distribution, and half-life. The PK and PD of the model drugs need to be integrated to predict their limitations. Conclusion: Current antiviral drugs have varying pharmacological constraints that may associate with limited efficacy, especially in severe COVID-19 patients, or safety concerns.