What Are Drug Prevention and Treatment Options for COVID-19?
Karen Berger, PharmD, graduated from the University of Pittsburgh School of Pharmacy in 2001. She has worked in community pharmacies for over 17 years as a Pharmacist in Charge, staff, and floater pharmacist for a large chain. Currently, she is a pharmacist at an independent pharmacy in Northern NJ. She can be reached at email@example.com
Several pharmaceutical companies are racing to develop an effective treatment for the virus that is now a global pandemic.
COVID-19 has changed life as we know it.
There is no preventive vaccine or specific treatment available, according to the CDC.
Control measures and infection prevention should be implemented, and patients should receive supportive care, as needed.
Patients who have mild symptoms and seek advice should be advised to drink fluids, self-quarantine for 14 days, and take OTC medication for fever or other symptoms. They should also contact their doctor for further advice and guidance to see if a coronavirus test is available and/or needed.
Those with difficulty breathing or shortness of breath and high fevers should be seen and may be admitted into the hospital for oxygen. Some patients even need a ventilator. They should, if possible, first call their local emergency department for instruction.
All patients should focus on prevention and social distancing. These tips from the CDC are helpful.
Several pharmaceutical companies are racing to develop an effective treatment for the virus that is now a global pandemic. There are several classes of drugs in development, including antivirals, immunotherapies, vaccinations, as well as other investigational options. It is unknown whether a single drug could work or if a combination is needed, similar to HIV treatment. Below is a table outlining each area.
Potential Mechanism of Action
Broad-spectrum antiviral tested in Japan
Has been used in a trial in mice with severe acute respiratory syndrome
Antiviral used for treatment of HIV; already on market
Both in China and Japan
Attacks RNA virus­es by in­hibit­ing RdRp (RNA-de­pen­dent RNA poly­merase)
Antiviral used for treatment of HIV; is already on market; protease inhibitor
Broad-spectrum antiviral that blocks RNA-dependent polymerase
Under investigation sponsored by National Institute of Health;
2 other phase 3 trials are going on simultaneously
Viral surface protein for binding to host cell receptor ACE2
Used in China and Russia
Potential Mechanism of Action
Anti-SARS-CoV-2 polyclonal hyperimmune globulin
Antibodies of plasma from recovered patients; will be transferred to sick patients in the future to improve immune response
Can potentially increase change of recovery
Mimics human innate immune system and causes disruption of membrane pathogens
Ready for phase 3 trials
N-methyl-d-aspartate receptor glutamate receptor antagonist
Preparing for US clinical trials. Animal study demonstrated reduction in acute lung injury and improved survivability in H5N1 infected animals.
Patented T cell modulation peptide delivery technology
Stimulated protective cell mediated T cell response and reduce viral load
Allogeneic mesenchymal stem cell can treat acute respiratory distress syndrome
Derived from bone marrow of unrelated donors and administered via intravenous infusions
Blocks IL-6 and can reduce inflammation
Deplete circulating levels of interleukin-6 (IL-6)
Can decrease chronic inflammation, which may be associated with the severe lung damage
Q BioMed/Mannin Research
Treatment of vascular leakage and endothelial dysfunction
Can potentially assist those who are very ill
Also important to note, the antimalarial drug chloroquine is being studied for the treatment of coronavirus. Hydroxychloroquine, a safer, less toxic metabolite of chloroquine, is also being studied. Chloroquine blocks viral entry in the endosome.
Note: corticosteroids should generally be avoided, because of their potential to prolong viral replication. In some cases, steroids may be indicated for other reasons.
Biomedical Advanced Research and Development Authority and Johnson & Johnson
To be determined using proprietary technology
mRNA vaccine to be used in a phase 1 study
Testing will begin with 45, young healthy volunteers
Multiple recombinant nanoparticle vaccines will enhance immune responses
Biomedical Advanced Research and Development Authority and Sanofi
Recombinant DNA platform formulated to stimulate the immune system to protect against the virus
Applied DNA Sciences and Takis Biotech
DNA vaccine candidate using polymerase chain reaction-based DNA (linear DNA)
This list is not all inclusive. Updates will be made
Karen Berger, PharmD, is a pharmacist at an independent pharmacy in northern New Jersey.
Suzanne Soliman, PharmD, BCMAS, is the founder and president of the Pharmacist Moms Group.