1.1 Broad-spectrum antiviral drug -Remdesivir
Currently, remdesivir is a potential drug against SARS-CoV-2 that is
being tested in randomized control trials. It is approved by the USFDA
for emergency medicine treatment. Remdesivir (formerly GS-5734) is a
monophosphate prodrug, which is metabolized to produce active
C-adenosine nucleoside triphosphate analogues. The drug was found in the
process of screening antibiotics with anti-RNA virus activity. It has a
low EC50 and its selectivity to the host polymerase of
the Ebola virus has developed drugs for the treatment of Ebola
infections (Siegel et al., 2017). Remdesivir is a potential therapeutic
agent for COVID-19 because of its broad-spectrum of activity and
effective in vitro antivirus activities.
According to previous data, remdesivir has a strong EC90value (1.76 μM) against COVID-19 in Vero E6 cells, and remdesivir also
inhibited human hepatoma cell line (human liver cancer Huh-7 cells),
which is sensitive to COVID-19 (M. Wang et al., 2020). The first
COVID-19 patient diagnosed in the United States has an improved clinical
status after intravenous injection of remdesivir (Holshue et al., 2020).
Three other hospitalized patients, with worsening clinical status,
received remdesivir, which inhibits viral replication by incorporating
into the nascent viral RNA and inhibiting the RNA-dependent RNA
polymerase (Mulangu et al., 2019). Meanwhile, in vitro studies
show that remdesivir inhibits SARS-CoV-2 replication in non-human cells
(”Clinical and virologic characteristics of the first 12 patients with
coronavirus disease 2019 (COVID-19) in the United States,” 2020). There
are successful case reports of remdesivir against COVID-19 infections.
There are 66 ongoing clinical trials to assess the drug’s safety and
antiviral activity in patients with mild, moderate, or severe COVID-19
(Sanders, Monogue, Jodlowski, & Cutrell, 2020). However, among the
crippling side effects of remdesivir, the commonest one is a reversible
increase in transaminases, which may cause kidney damage (Sheahan et
al., 2020). Therefore, its use still needs to be based on the specific
clinical situation of the patient (Table 1).