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SARS-CoV-2, the novel infectious causative factor of the new pandemic COVID-19 produced 5934936 total infected cases and 367166 death cases across multiple continents as of May 31, 2020. Majority of the world’s population are still vulnerable to COVID-19. As of now, there are no clear scientific proven treatment or drug to combat covid-19, but prevention and management can reduce the spread of virus. In this crisis, a vaccine, that can train the immune system to fight against this novel coronavirus becomes essential to control the further dissemination of the new pandemic COVID-19. This review provides insights into the on- going treatment options available for COVID-19 including antiviral drugs, Ayurvedic treatment, combination of drugs and plasma therapy. This review also aims to highlight on the development of vaccines and its clinical status.
Drosten C, Günther S, Preiser W, Van Der Werf S, Brodt, HR, Becker et al. Identification of a novel coronavirus in patients with severe acute respiratory syndrome. N Engl J Med. 2003;348:1967-1976.
Chen Y, Liu Q, Guo D. Emerging coronaviruses: Genome structure, replication and pathogenesis. J Med Virol. 2020;92:418-423.
Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, Zhao X, Huang B, Shi W, Lu R, Niu P. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382:727-733.
de Groot R J, Baker S, Baric R, Enjuanes L, Gorbalenya A, Holmes, et al. Family coronaviridae. Virus Taxonomy. 2012;806-28.
Malik YS, Sircar S, Bhat S, Sharun K, Dhama K, Dadar, et al. Emerging novel coronavirus (2019-nCoV)—current scenario, evolutionary perspective based on genome analysis and recent developments. Vet Quart. 2020;40:68-76.
Chan JFW, Yuan S, Kok KH, To KKW, Chu H, Yang, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: A study of a family cluster. Lancet. 2020;395:514-523.
Chen N, Zhou M, Dong X, Qu J, Gong F, Han, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395:507-513.
World Health Organization. Coronavirus disease (COVID-19) 2020: Situation report. 2019;132.
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497-506.
Ren LL, Wang YM, Wu ZQ, Xiang ZC, Guo L, Xu, et al. Identification of a novel coronavirus causing severe pneumonia in human: a descriptive study. Chin Med J; 2020.
Wang W, Tang J, Wei F. Updated understanding of the outbreak of 2019 novel coronavirus (2019‐nCoV) in Wuhan, China. J Med Virol. 2020;92:441-447.
Carlos WG, Dela Cruz, CS, Cao B, Pasnick S, Jamil S. Novel wuhan (2019-nCoV) coronavirus. Am J Respir Crit Care Med. 2020;201:P7-8.
Andersen KG, Rambaut A, Lipkin WI, Holmes EC, Garry RF. The proximal origin of SARS-CoV-2. Nat Med. 2020;26:450-452.
Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579:270-3.
Zhang T, Wu Q, Zhang Z. Probable pangolin origin of 2019-nCoV associated with outbreak of COVID-19. Curr Biol; 2020.
Forster P, Forster L, Renfrew C, Forster M. Phylogenetic network analysis of SARS-CoV-2 genomes. Proc Natl Acad Sci. 2020;117:9241–9243.
Wu F, Zhao S, Yu B, Chen YM, Wang W, Hu, et al. Complete genome characterisation of a novel coronavirus associated with severe human respiratory disease in Wuhan, China. bio Rxiv; 2020.
Kim D, Lee JY, Yang JS, Kim JW, Kim VN, Chang H. The architecture of SARS-CoV-2 transcriptome. Cell in press; 2020.
Wan Y, Shang J, Graham R, Baric RS, Li F. Receptor recognition by the novel coronavirus from Wuhan: An analysis based on decade-long structural studies of SARS coronavirus. J Virol 2020;94: e00127-20.
Wang H, Yang P, Liu K, Guo F, Zhang Y, Zhang G, Jiang C. SARS coronavirus entry into host cells through a novel clathrin-and caveolae-independent endocytic pathway. Cell Res. 2008;18:290-301.
Kuba K, Imai Y, Ohto-Nakanishi T, Penninger JM. Trilogy of ACE2: A peptidase in the renin–angiotensin system, a SARS receptor, and a partner for amino acid transporters. Pharmacol Therapeut 2010;128:119-28.
Perlman S, Netland J. Coronaviruses post-SARS: update on replication and pathogenesis, Nat Rev Microbiol. 2009;7: 439-50.
de Wit E, van Doremalen N, Falzarano D, Munster VJ. SARS and MERS: Recent insights into emerging coronaviruses. Nat Rev Microbiol. 2016;14:523-534.
Li G, Chen X, Xu A. Profile of specific antibodies to the SARS-associated coronavirus, N Engl J Med. 2003;349:508-09.
Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020;8:420-2.
National Health Commission of the people’s republic of China. Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (Trial version 7).
(Accessed March 29, 2020)
Stockman LJ, Bellamy R, Garner P. SARS: systematic review of treatment effects. PLoS Med. 2006;3:e343.
Chu CM, Cheng VCC, Hung IFN, Wong MML, Chan KH, Chan, et al. Role of lopinavir/ritonavir in the treatment of SARS: initial virological and clinical findings. Thorax. 2004;59:252-256
Momattin H, Al-Ali AY, Al-Tawfiq JA. A Systematic review of therapeutic agents for the treatment of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). Travel Med Infect Di. 2019;30:9-18.
Elfiky AA. Anti-HCV, nucleotide inhibitors, repurposing against COVID-19. Life Sci. 2020;117477.
Wang LF, Lin YS, Huang NC, Yu CY, Tsai WL, Chen, et al. Hydroxychloroquine-inhibited dengue virus is associated with host defense machinery. J Interferon Cytokine Res. 2015;35:143-156.
Wang M, Cao R, Zhang L, Yang X, Liu J, Xu, et al. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Cell Res. 2020;30:269-271.
Arbidol and Darunavir can effectively inhibit coronavirus.
(Accessed February 21, 2020) (In Chinese)
Furuta Y, Komeno T, Nakamura T. Favipiravir (T-705), a broad spectrum inhibitor of viral RNA polymerase. P Jpn Acad B-Phys. 2017;93:449-463.
Holshue ML, DeBolt C, Lindquist S, Lofy KH, Wiesman J, Bruce, et al. First case of 2019 novel coronavirus in the United States. N Engl J Med. 2020;382:929-936.
Li G, De Clercq E. Therapeutic options for the 2019 novel coronavirus (2019-nCoV). Nature Rev Drug Discov. 2020;19:149-150.
Xu Z, Peng C, Shi Y, Zhu Z, Mu K, Wang X, Zhu W. Nelfinavir was predicted to be a potential inhibitor of 2019-nCov main protease by an integrative approach combining homology modelling, molecular docking and binding free energy calculation. BioRxiv; 2020.
Chen L, Gui C, Luo X, Yang Q, Günther S, Scandella, et al. Cinanserin is an inhibitor of the 3C-like proteinase of severe acute respiratory syndrome coronavirus and strongly reduces virus replication in vitro. J Virol. 2005;79:7095-7103.
Jo S, Kim S, Shin DH, Kim MS. Inhibition of SARS-CoV 3CL protease by flavonoids. J Enzym Inhib Med Ch 2020;35:145-151.
Liu W, Morse JS, Lalonde T, Xu S. Learning from the past: possible urgent prevention and treatment options for severe acute respiratory infections caused by 2019‐nCoV. Chembiochem. 2020;21: 730-38.
Park JY, Jeong HJ, Kim JH, Kim YM, Park SJ, Kim, et al. Diarylheptanoids from Alnus japonica inhibit papain-like protease of severe acute respiratory syndrome coronavirus. Biol Pharma Bull 2012;35: 2036-042.
Hoffmann M, Kleine-Weber H, Krüger N, Mueller MA, Drosten C, Pöhlmann S. The novel coronavirus 2019 (2019-nCoV) uses the SARS-coronavirus receptor ACE2 and the cellular protease TMPRSS2 for entry into target cells. BioRxiv; 2020.
Coleman CM, Sisk JM, Mingo RM, Nelson EA, White JM, Frieman MB. Abelson kinase inhibitors are potent inhibitors of severe acute respiratory syndrome coronavirus and Middle East respiratory syndrome coronavirus fusion. J Virol 2016; 90:8924-8933.
Channappanavar R, Perlman S. Pathogenic human coronavirus infections: causes and consequences of cytokine storm and immunopathology. In Seminars in immunopathology, Springer Berlin Heidelberg. 2017;39:529-539.
Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, & Manson JJ. COVID-19: Consider cytokine storm syndromes and immunosuppression. Lancet 2020;395: 1033-1034.
Luo P, Liu Y, Qiu L, Liu X, Liu D, & Li J. Tocilizumab treatment in COVID‐19: A single center experience. J Med Virol 2020;1-5.
Sanofi and Regeneron begin global Kevzara (sarilumab) clinical trial program in patients with severe COVID-19.
(Accessed March 18, 2020)
(Accessed March 18, 2020)
Richardson P, Griffin I, Tucker C, Smith D, Oechsle O, Phelan A, Stebbing J. Baricitinib as potential treatment for 2019-nCoV acute respiratory disease. Lancet (London, England). 2020;395:e30.
Varshney A, Balkrishna A, & Singh J. Withanone from Withania somnifera May Inhibit Novel Coronavirus (COVID-19) Entry by Disrupting Interactions between Viral S-Protein Receptor Binding Domain and Host ACE2 Receptor. BMC virology; 2020.
Sagar V, Kumar AH. Efficacy of Natural Compounds from Tinosporacordifolia against SARS-CoV-2 protease, Surface Glycoprotein and RNA Polymerase. BEMS Reports. 2020;6.
Gupta PK, Chakraborty P, Kumar S, Singh PK, Rajan MGR, Sainis KB, Kulkarni S. G1-4A, a polysaccharide from Tinospora cordifolia inhibits the survival of Mycobacterium tuberculosis by modulating host immune responses in TLR4 dependent manner. PLoS One. 2016;11: e0154725
Yu MS, Lee J, Lee JM, Kim Y, Chin YW, Jee, et al. Identification of myricetin and scutellarein as novel chemical inhibitors of the SARS coronavirus helicase, nsP13. Bioorg Med Chem Lett. 2012;22: 4049-4054.
Balkrishna, A. Indian Traditional Ayurvedic Treatment Regime for Novel Coronavirus, COVID-19; 2020.
Wang L, Yang R, Yuan B, Liu Y, Liu C. The antiviral and antimicrobial activities of licorice, a widely-used Chinese herb. Acta Pharm Sin B. 2015;5:310-315.
Li Q, Guan X, Wu P, Wang X, Zhou L, Tong, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus–infected pneumonia. N Engl J Med. 2020; 382:1199-07
Carrasco FR, Schmidt G, Romero AL, Sartoretto JL, Caparroz‐Assef SM, Bersani‐Amado CA, Cuman RKN. Immunomodulatory activity of Zingiber officinale Roscoe, Salvia officinalis L. and Syzygium aromaticum L. essential oils: evidence for humorand cell‐mediated responses. J Pharm Pharmacol. 2009;61: 961-967.
Kim SH, Lee YC. Piperine inhibits eosinophil infiltration and airway hyperresponsiveness by suppressing T cell activity and Th2 cytokine production in the ovalbumin‐induced asthma model. J Phar Pharmacol. 2009;61:353-359.
Bui TT, Fan Y, Piao CH, Van Nguyen T, Shin DU, Jung, et al. Piper Nigrum extract improves OVA-induced nasal epithelial barrier dysfunction via activating Nrf2/HO-1 signaling. Cell Immunol. 2019;104035.
Sordillo PP, Helson L. Curcumin suppression of cytokine release and cytokine storm. A potential therapy for patients with Ebola and other severe viral infections. in vivo. 2015;29:1-4.
Gautret P, Lagier JC, Parola P, Meddeb L, Mailhe M, Doudier, et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: Results of an open-label non-randomized clinical trial. Int J Antimicrob. 2020:105949.
Ivermectin with antibiotic doxycycline works to treat covid-19 patients.
(Accessed March 19, 2020)
Hifumi T, Yamamoto A, Ato M, Sawabe K., Morokuma K, Morine, et al. Clinical serum therapy: Benefits, cautions and potential applications. The Keio J Med. 2017;2016-0017.
Marano G, Vaglio S, Pupella S, Facco G, Catalano L, Liumbruno GM, Grazzini G. Convalescent plasma: New evidence for an old therapeutic tool?. Blood Transfusion. 2015;14:152.
Mair-Jenkins J, Saavedra-Campos M, Baillie JK, Cleary P, Khaw FM, Lim et al. The effectiveness of convalescent plasma and hyperimmune immunoglobulin for the treatment of severe acute respiratory infections of viral etiology: a systematic review and exploratory meta-analysis. J Infect. 2015; 211:80-90.
Shen C, Wang Z, Zhao F, Yang Y, Li J, Yuan et al. Treatment of 5 critically ill patients with COVID-19 with convalescent plasma. Jama. 2020;323:1582-1589.
Bloch EM, Shoham S, Casadevall A, Sachais BS, Shaz B, Winters et al. Deployment of convalescent plasma for the prevention and treatment of COVID-19. J Clin Invest; 2020.
Zhao Q, He Y. Challenges of convalescent plasma therapy on COVID-19. J Clin Virol. 2020;104358.
World Health Organization. Draft landscape of Covid-19 candidate vaccines.
(Accessed May 30, 2020)
Jiang S, Bottazzi ME, Du L, Lustigman S, Tseng CT, Curti E, et al. Roadmap to developing a recombinant coronavirus S protein receptor-binding domain vaccine for severe acute respiratory syndrome. Expert Rev Vaccines. 2012;11:405– 13.
Clover Biopharmaceuticals. Clover initiates development of recombinant subunit-trimer vaccine for Wuhan coronavirus (2019-nCoV); 2020.
Wang F, Kream RM, Stefano GB. An evidence based perspective on mRNA-SARS-CoV-2 Vaccine Development. Medical Science Monitor. Med Sci Monit. 2020;26:e924700-1.