Mem Inst Oswaldo Cruz, Rio de Janeiro, FAST TRACK
COVID-19: drug repurposing and new insights for drug discovery
1LaBECFar – Laboratório de Bioquímica Experimental e Computacional de Fármacos, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
2LaSOPB – Laboratório de Síntese Orgânica e Prospecção Biológica, Instituto de Química, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
Coronavirus Disease 2019 (COVID-19) caused by the SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) is a highly contagious infection that may break the healthcare system of several countries. The major clinical characteristics are high fever, dry cough, and difficulty in breathing that ultimately can lead to a multi-organ failure and septic shock causing patient death. If left unattended, the COVID-19 pandemic can last for several months or even years bringing an unacceptable death toll and devastating consequences to the global economy. Drug repurposing, i.e. when known drugs are evaluated to treat new diseases, has the potential to be the swiftest response to this health emergency. This strategy can reduce time and financial investment, lower the risk of failure and take advantage of a consolidated pharmaceutical supply chain for drug production and distribution to patients that effectively needs treatment. In this review we aimed at presenting a critical view of ongoing drug repurposing efforts for COVID-19 as well as discussing opportunities for development of new treatments based on current knowledge of the mechanism of infection and potential targets within. At this moment, only a few studies have suggested potentially effective treatments for COVID-19. Most proposals are based on preliminary computational approaches, in vitro studies and previous studies on other viruses, pathogens, or diseases. Randomized, double-blind, placebo-controlled clinical trials are still needed to effectively tackle the COVID-19 pandemic. Finally, we also discuss patent protection issues, cost effectiveness and scalability of synthetic routes for some of the most studied repurposing candidates since these are key aspects to meet global demand for COVID-19 treatment.