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Anales de la Facultad de Ciencias Médicas (Asunción)

Print version ISSN 1816-8949

Abstract

PASTRIAN SOTO, Gabriel. Potential therapeutic agents against COVID-19 based on blocking and inhibition of the viral life cycle and the cytokine storm syndrome. An. Fac. Cienc. Méd. (Asunción) [online]. 2020, vol.53, n.3, pp.131-146. ISSN 1816-8949.  https://doi.org/10.18004/anales/2020.053.03.131.

The COVID-19 pandemic, caused by SARS-CoV-2, is considered as the major health emergency in a century. Clinically, most patients have mild to moderate symptoms. Nevertheless, elderly or with comorbidities patients may develop one of the most severe complication of COVID-19, that is, the cytokine storm syndrome. Currently, there are no approved treatments for SARS-CoV-2. Meanwhile, therapeutic strategies are based on previous experience with other viruses. This article will review the different therapeutic agents proposed for the treatment of COVID-19 based on the blocking and inhibition of the viral life cycle of SARS-CoV-2, and for the treatment of cytokine storm syndrome. A narrative review was performed by searching in the PubMed database. Among the main therapeutic target against SARS-CoV-2 are the major structural protein Spike and viral enzymes 3-chymotrypsin-like protease, viral papain-like protease, and RNA-dependent RNA polymerase. Remdesivir, an adenosine analogue antiviral that inhibits RNA-dependent RNA polymerase, is considered the most promising drug in the treatment of COVID-19. Nonetheless, its efficacy has not yet been determined. In the cytokine storm syndrome, the tissue injury caused by the virus may induce the exaggerated production of pro-inflammatory cytokines such as interleukin-6. Tocilizumab, a monoclonal antibody that blocks interleukin-6 receptors, and corticosteroids such as methylprednisolone may be therapeutic options in treating the severity of the syndrome.

Keywords : COVID-19; SARS-CoV-2; Therapeutics; Virus replication; Cytokines..

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