COVID-19-Current Therapeutical Approaches and Future Perspectives

Round 1

Reviewer 1 Report

The authors of the review, "Covid-19 - current therapeutical approaches and future perspectives", have done an excellent job by reviewing the  current and new therapeutical approaches, summarizing the viral structure and life cycle, with an emphasis on the specific steps that can be interfered by antivirals especially inhibition of viral entry with anti-spike monoclonal antibodies, inhibition of the RNA genome replication with nucleosidic analogs blocking the viral RNA polymerase, and inhibition of the main viral protease (Mpro), which directs the formation of the nonstructural proteins. The authors have also highlighted the immunomodulatory drugs currently used for severe COVID-19 treatment and the future therapeutical options. This review of literature includes all the relevant and updated information about the COVID-19 treatments in use. I would recommend the publication of this manuscript after carefully correcting for minor typos.

Author Response

Dear reviewer,

Thank you for your interest in our work and for your recommendation. As indicated in the provided document, we have checked all the typos and updated the paper accordingly.

Author Response File: Author Response.docx

Reviewer 2 Report

The aim of this manuscript is to review the current and pending approved treatment options for COIVD pneumonia. The author reviewed SARS-CoV-2 structure, life cycle and different mechanism of current therapeutic management.

1. A lot of review and guideline has been published for the COVID pneumonia treatment. To become unique review in this topic, the author could focus on the molecular mechanism of current and pending pharmatheutical treatment.
2. A schematic of Viral structure, life cycle and infectious mechanism would be very helpful for the reader.
3. A schematic of each COVID medications’ mechanisms discussed in this review would be very helpful.
4. Current COVID treatment mainly separate into Outpatient treatment and Inpatient treatment guideline, it would be better to divided “3. Drugs currently used for COVID 19 therapy” into Outpatient medication and Inpatient medications.
5. A comment side effect and contraindication should be reviewed in each medications.

Author Response

Dear Reviewer,

Thank you for your interest in our work and for the useful comments that helped us greatly improve our paper. As indicated below, we have checked all comments provided by you and changed the paper accordingly.

Point 1: A lot of review and guideline has been published for the COVID pneumonia treatment. To become a unique review in this topic, the author could focus on the molecular mechanism of current and pending pharmatheutical treatment.

Response 1: Indeed, a lot of reviews on the COVID-19 topic was published since the beginning of this pandemic, and also an increased number of guidelines regarding therapy were published. This is the main reason why we’ve decided to approach the topic of current medication based on their specific targets in the viral life cycle and to synthetise the future therapeutic perspectives in order to summarize what is known to date.

Point 2: A schematic of Viral structure, life cycle, and infectious mechanism would be very helpful for the reader. 

Response 2: As you mentioned in point 1, numerous reviews and guidelines for the treatment of COVID pneumonia have been published, which contain an overview of the viral structure, life cycle, or infectious mechanism. We consider that an image of the life cycle will be no longer an original work, as many schemes and images are already presented in the literature, creating a completely new one will be extremely difficult.Still, as you have suggested, we added short paragraphs that explain in deep the viral structure and life cycle, which can be helpful for the reader.

Point 3: A schematic of each COVID medication’s mechanisms discussed in this review would be very helpful.

As you have recommended, we added a figure (Figure 1). Diagram of direct acting antivirals in SARS CoV-2 infection) containing a diagram of SARS CoV-2 direct inhibitors and their mechanism of action.

Point 4: Current COVID treatment mainly separate into Outpatient treatment and Inpatient treatment guideline, it would be better to divided “3. Drugs currently 

Response 4: We have introduced a table (the classification of the drugs described in the paper), which also includes the classification into Outpatient and Inpatient recommendations.

Point 5: A comment side effect and contraindication should be reviewed in each medications.

Response 5: For some of the drugs mentioned in the paper this information was already included, but we have updated the text accordingly, with supplementary data for all the drugs described.

Author Response File: Author Response.docx

Round 2

Reviewer 2 Report

The author properly response all the reviewer's comments with much improvement of the manuscript. This should be consider to be published in the journal.