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World J Clin Cases. Aug 16, 2021; 9(23): 6663-6673
Published online Aug 16, 2021. doi: 10.12998/wjcc.v9.i23.6663
Theory and reality of antivirals against SARS-CoV-2
Bo Zhao, Teng-Fei Yang, Rui Zheng
Bo Zhao, Rui Zheng, Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
Teng-Fei Yang, Department of Health Management and Family Medicine, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
Author contributions: Zheng R and Zhao B conceptualized and designed the study, drafted the initial manuscript, and reviewed and revised the manuscript; Yang TF prepared the figures and tables.
Supported by the 345 Talent Project of Shengjing Hospital of China Medical University.
Conflict-of-interest statement: The authors declare that they have no competing interests to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rui Zheng, MD, PhD, Chief Physician, Deputy Director, Professor, Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang 110004, Liaoning Province, China. zhengr@sj-hospital.org
Received: March 17, 2021
Peer-review started: March 17, 2021
First decision: April 4, 2021
Revised: April 16, 2021
Accepted: July 2, 2021
Article in press: July 2, 2021
Published online: August 16, 2021
Abstract

At present, over 180 million people have been infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) worldwide and there have been more than 3.8 million deaths due to the virus. However, specific effective antiviral treatment for this infectious disease is absent. At the beginning of the epidemic, relevant cellular and animal experiments of antiviral treatment for SARS-CoV-2 were conducted based on the prior studies of SARS-CoV and Middle East respiratory syndrome coronavirus. Some antivirals were preliminarily validated to be potentially effective in the clinical settings. But as the epidemic continued and more studies were carried out, the efficacy of these antiviral drugs became controversial. This paper reviews the pharmacology and application of interferon, lopinavir/ritonavir, ribavirin, chloroquine, arbidol, favipiravir, remdesivir, and thymosin α1 in coronavirus disease 2019. The actual effect of these drugs remains controversial. Meanwhile, the efficacy and safety of these drugs for patients with coronavirus disease 2019 still need to be explored.

Keywords: SARS-CoV-2, Antivirals, Efficacy, Safety, Middle East respiratory syndrome coronavirus

Core Tip: This paper reviews the pharmacology and application of interferon, lopinavir/ritonavir, ribavirin, chloroquine, arbidol, favipiravir, remdesivir, and thymosin α1 in coronavirus disease 2019 (COVID-19). The actual effect of these drugs remains controversial. Meanwhile, the efficacy and safety of these drugs for patients with COVID-19 still need to be explored.