Are nucleotide inhibitors, already used for treating hepatitis C virus infection, a potential option for the treatment of COVID-19 compared with standard of care? A literature review

Abstract

Coronavirus disease 2019 (COVID-19) is global pandemic with various clinical presentations, ranging from cold to sometimes unrecoverable acute respiratory distress syndrome. Although urgently needed, currently there are no specific treatments for COVID-19. Repurposing existing pharmaceuticals to treat COVID-19 is crucial to control the pandemic. In silico and in vitro studies suggest that a nucleotide inhibitor called Sofosbuvir, has also antiviral activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), apart from suppressing other positive-strand ribonucleic Acid viruses with conserved polymerase (hepatitis C virus). The aim of this study was to assess if Sofosbuvir improves clinical outcomes in patients with moderate or severe COVID-19. A compre-hensive overview of scientific literature has been made. Terms searched in PubMed were: COVID-19, SARS-CoV-2, nucleotide inhibitors, pandemic, Sofosbuvir. Results clinical trials conducted among adults with moderate or severe COVID-19 were analyzed. Patients were divided in treatment and control arms, receiving Sofosbuvir plus standard care and standard care alone respectively. The addition of Sofosbuvir to standard care significantly reduced the duration of hospital stay compared with standard care alone in clinical trials examined. If efficacy of these repurposed, cheap and easily available drug against SARS-CoV-2 is further demonstrated, it could be essential to refine the treatment of COVID-19.

Keywords: COVID-19; SARS-CoV-2; Pandemic; Nucleotide inhibitors; Sofosbuvir; Coronavirus

Core Tip: Coronavirus disease 2019 represents a terrible, still unsolved, global problem affecting not only the healthcare system but also the economic and social one. All countries are facing and fighting against this pandemic but there is still no specific treatment for its eradication. Recently some nucleotide inhibitors, already approved and employed for the treatment of hepatitis c virus infection, have been repurposed for treatment of severe acute respiratory syndrome coronavirus 2 infection, because of some common features among coronaviruses and hepatitis c virus. Herein briefly I focused on the effects of this compound on coronavirus disease 2019, based on its pharmacokinetic properties and on results of several completed clinical trials.