A Review of SARS-CoV-2 and the Ongoing Clinical Trials

The sudden outbreak of 2019 novel coronavirus (2019-nCoV, later named SARS-CoV-2) in Wuhan, China, which rapidly grew into a global pandemic, marked the third introduction of a virulent coronavirus into the human society, affecting not only the healthcare system, but also the global economy. Althoug...

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Bibliographic Details
Published in:	International journal of molecular sciences 2020-04, Vol.21 (7), p.2657
Main Authors:	Tu, Yung-Fang, Chien, Chian-Shiu, Yarmishyn, Aliaksandr A, Lin, Yi-Ying, Luo, Yung-Hung, Lin, Yi-Tsung, Lai, Wei-Yi, Yang, De-Ming, Chou, Shih-Jie, Yang, Yi-Ping, Wang, Mong-Lien, Chiou, Shih-Hwa
Format:	Article
Language:	eng
Subjects:	Antibodies Antiviral agents Antiviral Agents - therapeutic use Betacoronavirus - chemistry Betacoronavirus - genetics Betacoronavirus - immunology Betacoronavirus - physiology Chemical compounds Clinical trials Clinical Trials as Topic Coronaviridae Coronavirus Infections - diagnosis Coronavirus Infections - drug therapy Coronavirus Infections - epidemiology Coronavirus Infections - prevention & control Coronavirus Infections - therapy Coronavirus Infections - virology Coronaviruses COVID-19 COVID-19 Drug Treatment COVID-19 Serotherapy COVID-19 Vaccines Drug development Epidemiology Fatalities Genome, Viral Genomes Global economy Humans Hydroxychloroquine Immune response Immunization, Passive Immunologic Factors - therapeutic use Immunosuppressive agents Immunotherapy Inflammation Middle East respiratory syndrome Outbreaks Pandemics Pharmacology pneumonia Pneumonia, Viral - diagnosis Pneumonia, Viral - epidemiology Pneumonia, Viral - therapy Pneumonia, Viral - virology Replication Respiratory diseases Review Reviews SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 vaccine Vaccines Viral diseases Viral Vaccines Viruses
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Summary:	The sudden outbreak of 2019 novel coronavirus (2019-nCoV, later named SARS-CoV-2) in Wuhan, China, which rapidly grew into a global pandemic, marked the third introduction of a virulent coronavirus into the human society, affecting not only the healthcare system, but also the global economy. Although our understanding of coronaviruses has undergone a huge leap after two precedents, the effective approaches to treatment and epidemiological control are still lacking. In this article, we present a succinct overview of the epidemiology, clinical features, and molecular characteristics of SARS-CoV-2. We summarize the current epidemiological and clinical data from the initial Wuhan studies, and emphasize several features of SARS-CoV-2, which differentiate it from SARS-CoV and Middle East respiratory syndrome coronavirus (MERS-CoV), such as high variability of disease presentation. We systematize the current clinical trials that have been rapidly initiated after the outbreak of COVID-19 pandemic. Whereas the trials on SARS-CoV-2 genome-based specific vaccines and therapeutic antibodies are currently being tested, this solution is more long-term, as they require thorough testing of their safety. On the other hand, the repurposing of the existing therapeutic agents previously designed for other virus infections and pathologies happens to be the only practical approach as a rapid response measure to the emergent pandemic, as most of these agents have already been tested for their safety. These agents can be divided into two broad categories, those that can directly target the virus replication cycle, and those based on immunotherapy approaches either aimed to boost innate antiviral immune responses or alleviate damage induced by dysregulated inflammatory responses. The initial clinical studies revealed the promising therapeutic potential of several of such drugs, including , a broad-spectrum antiviral drug that interferes with the viral replication, and , the repurposed antimalarial drug that interferes with the virus endosomal entry pathway. We speculate that the current pandemic emergency will be a trigger for more systematic drug repurposing design approaches based on big data analysis.
ISSN:	1422-0067 1661-6596 1422-0067