Table 1.
Anti-viral drugs clinically evaluated in COVID-19.
| Drug | Target/MOA⁎ | Route of administration | Clinical Trials | Side effects |
|---|---|---|---|---|
| Drugs targeting viral components | ||||
| Remdesivir | RdRp inhibitor [61,62] | IV [61] |
Monotherapy:NCT04365725, NCT04280705, NCT04582266, NCT04431453, NCT04539262, NCT04501952, NCT04345419 In Combination: NCT04409262 + Tocilizumab, NCT04401579 + Baricitinib, NCT04492475 + Interferon beta-1a, NCT04583969 + Lenzilumab, NCT04583956 + Risankizumab, NCT04480333+ NA-831. NCT04410354+ Merimepodib, NCT04315948+SoC, NCT04292899+SoC, NCT04292730+SoC, NCT04330690+ standard supportive care |
Abnormal liver function, diarrhea, rashes, renal impairment, and hypotension [61] |
| Arbidol | Viral fusion [11] | Oral [51] |
Monotherpay:, NCT04255017, ChiCTR2000030254 In Combination:NCT04252885+ standard treatment, NCT04260594 + basic treatment, NCT04350684+ Interferon-β 1a + Lopinavir / Ritonavir + Single Dose of Hydroxychloroquine |
Minimal; Abnormal LFT, GIT reactions [51,63] |
| Lopinavir/ ritonavir | 3CLpro and/or Plpro. inhibitor [62,64] | Oral [49] |
Monotherapy:NCT04372628 NCT04255017, NCT04321174 In Combination: NCT04276688+ IFNβ-1B + Ribavirin NCT04303299+ Chloroquine or darunavir or Oseltamivir or Favipiravir, NCT04320277+ Baricitinib, NCT04499677+ Favipiravir, NCT04403100+ Hydroxychloroquine, NCT04346147+ Hydroxychloroquine, NCT04252885+ standard treatment |
Anorexia, nausea, abdominal discomfort, diarrhea, hepatic injury, pancreatitis, cutaneous eruptions, QT prolongation. [49] |
| Favipiravir | RdRp inhibitor [11,62] | Oral [63] |
Monotherapy: ChiCTR2000030254, NCT04349241, NCT04333589, NCT04542694NCT04351295, NCT04448119 In combination: ChiCTR2000029600 + IFNα, NCT04359615+ hydroxychloroquine, NCT04303299+ lopinavir + ritonavir or chloroquine or darunavir, NCT04310228 + tocilizumab, NCT04558463+ standard therapy, NCT04532931+ Nitazoxanide, NCT04376814+ hydroxychloroquine, NCT04358549+SoC, NCT04346628+SoC |
Minimal side effects; raised serum uric acid, abnormal LFT, GIT reactions [50,63] |
| Ribavirin | RdRp inhibitor [62] | IV, Oral [17], Inhalation [47] |
Monotherapy:NCT04356677, NCT04551768 In combination: NCT04276688+ Lopinavir/ ritonavir+ IFNβ, NCT04563208+ Nitazoxanide, NCT04494399+ IFN β-1b + SoC, NCT04392427+ Nitazoxanide+ Ivermectin |
Teratogenic Hemolytic anemia [65], mild lymphopenia, hyperuricemia, itching, rash, cough and nasal stuffiness [66] |
| Darunavir | 3CLpro inhibitor [62] | Oral [67] | In combination:NCT04252274+Cobicistat, NCT04303299+ritonavir+ lopinavir or oseltamivir or favipiravir or chloroquine. | Skin rash [67] |
| Oseltamivir | Neuraminidase inhibitor [68] | Oral [69] |
Monotherapy:NCT04255017 In combination:NCT04303299+ lopinavir+ ritonavir or chloroquine or darunavir, NCT04516915 + Vidofludimus calcium, NCT04338698 + Hydroxychloroquine + Azithromycin, NCT04261270+Ritonavir+ ASC09F, NCT04558463+standard therapy |
Nausea and vomiting [70] |
| Drugs targeting host cell components | ||||
| Hydroxychloroquine⁎ | Preventing viral entry and transport [53] | Oral [52] |
Monotherapy:NCT04497519, NCT04466540, NCT04435808, NCT04429867, NCT04461353 In combination:NCT04336332 + Azithromycin, NCT04355026 + Bromhexine, NCT04338906+ Camostat mesilate NCT04355052+ Camostat mesylate or Azithromycin, NCT04391127+ Ivermectin, NCT04261517+conventional treatment, NCT04477083+supportive treatment, NCT04458948+ Azithromycin |
Pruritus, headaches, dizziness, GIT disturbances, psychiatric effects, retinal toxicity, cardiotoxicity including cardiomyopathy and rhythm disorders QT prolongation and arrhythmias [54,71] |
| Chloroquine⁎ | Oral and IV [72] | Monotherapy:NCT04303507, NCT04351724, NCT04323527, NCT04344951, NCT04345419In combination:NCT04428268+Losartan, NCT04351191+SoC, NCT04328493+SoC | ||
| Baricitinib⁎ | Inhibition of viral endocytosis [73] | Oral [74] | Monotherapy:NCT04321993, NCT04340232, NCT04421027In combination:NCT04320277 +Lopinavir+Ritonavir, NCT04346147+hydroxychloroquine, NCT04373044+ Hydroxychloroquine | Impairment of IFN mediated antiviral response increasing risk of other viral infections [73] |
| Camostat mesilate | TMPRSS2 inhibitor [75] | Oral [75] |
Monotherapy: NCT04321096, NCT04353284, NCT04455815, NCT04374019, NCT04530617 In combination: NCT04338906+ hydroxychloroquine, NCT04355052+hydroxychloroquine, NCT04583592+SoC, NCT04470544+SoC |
Thrombocytopenia, hyperkaliemia, hepatotoxicity, anaphylactic shock, nausea, abdominal discomfort, abdominal fullness, diarrhea, rash, pruritus [76] |
| Nafamostat mesilate | protease TMPRSS2 inhibitor [77] | IV [77] |
Monotherapy:NCT04473053 In combination:NCT04352400+SoC, NCT04390594+SoC |
Agranulocytosis, hyperkalemia, hypotension, dyspnea, anaphylactic shock, abdominal pain, nausea, vomiting, anorexia, myalgia and arthralgia. [[78], [79], [80]] |
| Recombinant Human Angiotensin-converting Enzyme 2 (APN01) | Blocking cell entry via ACE2 [81] | IV [82] | Monotherapy:NCT04335136 | Diarrhea, rash, hypernatremia [82] |
| Recombinat IFN# IFN-α2β IFN-β1 |
Direct inhibition of viral replication and supporting an immune response for viral clearance [83] | Inhalation, oral [84] Subcutaneous injection [48] |
Monotherapy: In combination:NCT04276688 +Lopinavir/ Ritonavir+ Ribavirin, NCT04465695+ Clofazimine, NCT04350281+ Hydroxychloroquine, NCT04494399+ Ribavirin, NCT04293887+standard therapy, NCT04469491+SoC |
Neuropsychiatric adverse effects [85] |
LFT: Liver function tests, PLpro: Papain-like protease, 3CLpro: 3-chymotrypsin-like protease (Coronavirus main proteinase), RdRp: RNA-dependent RNA polymerase, TMPRSS2: Transmembrane serine protease 2, IFN-β1: Interferon beta-1, SoC: Standard of care.