Potential Pharmacological Options Against the Coronavirus

Abstract

Background: The emergence of the novel coronavirus (2019-nCoV) and the resulting COVID-19 disease initiated a global pandemic, threatening human lives and societies on an unprecedented scale. While three previous coronavirus epidemics have been documented, the 2019 outbreak distinguished itself through its rapid global spread and multifaceted transmission pathways, swiftly escalating into a worldwide health emergency. Objective: This study aimed to analyze previous coronavirus epidemics by comparing their outcomes with the recent COVID-19 pandemic. A further objective was to discuss pharmacological agents demonstrating potential in-vitro and in-vivo activity against the virus, with a critical focus on the evidence for remdesivir and chloroquine. Methods: A comparative analysis was conducted, evaluating the epidemiological trajectories and outcomes of previous coronavirus outbreaks against the COVID-19 pandemic. Additionally, a review of scientific literature was performed to identify and assess pharmacological agents with reported anti-COVID-19 activity in both laboratory and animal studies. Main Outcome Measures: The primary outcomes were the comparative transmissibility and scale of the COVID-19 pandemic relative to previous coronavirus epidemics, and the summarized preclinical evidence for the efficacy of selected pharmacological agents. Results: The analysis confirmed that the COVID-19 pandemic spread more rapidly and extensively than previous coronavirus epidemics. The review identified several agents with promising in-vitro and in-vivo activity. However, the capacity of remdesivir and chloroquine for treatment and prevention remains a subject of intense debate, underpinned by premature findings, a lack of robust clinical trials, and significant concerns regarding long-term safety. Conclusion: The COVID-19 pandemic represents a significant escalation in the threat posed by coronaviruses. While certain drugs show preclinical promise, the evidence for their clinical application, particularly for chloroquine and remdesivir, is insufficient and often conflicting. This underscores the critical and urgent need for large-scale, rigorous clinical trials to establish safe and effective therapeutic protocols.