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COVID-19 Innovative Drug Treatments: Looking for the Magic Cure to End the Pandemic

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Pharmacology".

Deadline for manuscript submissions: closed (31 May 2023) | Viewed by 12998

Special Issue Editors

Prof. Dr. George J. Kontoghiorghes

E-Mail Website
Guest Editor
Postgraduate Research Institute of Science, Technology, Environment and Medicine, CY-3021 Limassol, Cyprus
Interests: chelation therapy; chelation in medicine; chelating drugs; iron chelating drugs in thalassaemia and other diseases of iron overload or imbalance; chelator antioxidants in free radical pathology; chelators and antioxidants in cancer and neurodegenerative diseases; chelating drug design, development and clinical use
Special Issues, Collections and Topics in MDPI journals
Dr. Christina N. Kontoghiorghe

E-Mail Website
Guest Editor
Postgraduate Research Institute of Science, Technology, Environment and Medicine, CY-3021 Limassol, Cyprus
Interests: medicine; surgery; trauma; orthopaedics; global health; medicinal drugs; orphan drugs; risk/benefit assessment; sports medicine
Special Issues, Collections and Topics in MDPI journals
Dr. Annita Kolnagou

E-Mail Website
Guest Editor
Postgraduate Research Institute of Science, Technology, Environment and Medicine, CY-3021 Limassol, Cyprus
Interests: medicine; internal medicine; medicinal drugs; thalassaemia; Friedreich's Ataxia; infectious diseases
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues, 

The Special Issue follows the publication of the first volume on “COVID-19 Innovative Drug Treatments: Looking Outside of Plato’s Cave”, which presented 10 high-quality papers.

A high rate of morbidity and mortality, exceeding 5.3 million deaths by 2021, has been observed worldwide as a result of the COVID-19 pandemic that is caused by the coronavirus SARS-CoV-2 infection. Currently, there is no available effective treatment and more than 99% of the infected individuals survive the infection. Many clinical trials with antiviral and other drugs are in progress, but the availability of effective vaccines or the introduction of effective drugs to stop the pandemic has not yet been achieved. The economic decline from the emergency restrictions is causing unprecedented damage to living standards, including a decline in healthcare systems and increases in morbidity and mortality of other diseases worldwide, especially in developing countries. Emergency strategies and medicines are required to combat the COVID-19 pandemic, including unconventional approaches. There are many pathways involved in the initiation and progression of the COVID-19 infection, and many more associated with the severe acute respiratory syndrome (SARS) and other symptomatological side effects. The aim of this Special Issue is to propose possible therapeutics and related mechanisms for targeting one or more pathways or biomolecules, in order to combat the progress of the COVID-19 disease and/or associated symptoms, as well as to diminish the high rate of mortality. The proposal for therapeutics includes investigational new drugs (IND) and regulatory approved drugs, where in the latter group the authors should include the chemical structure, INN name, mode of action, posology, therapeutic index, toxic side effects, ADMET characteristics, patient categories receiving the drug, drug interactions, and use in adjuvant therapies. We hope that the findings and strategies adopted in this Special Issue will encourage clinical trials and the compassionate use of promising therapeutics against COVID-19 infection, which can lead to the end of the pandemic.

Prof. Dr. George J. Kontoghiorghes
Dr. Christina N. Kontoghiorghe
Dr. Annita Kolnagou
Guest Editors

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Keywords

  • drug design, development and use
  • COVID-19 drugs
  • SARS-CoV-2
  • multi-target drugs
  • antiviral drugs
  • drugs for COVID-19 symptomatology
  • repurposing drugs
  • prophylactic drugs
  • emergency medicines
  • combination therapies
  • adjuvant therapies
  • drug risk/benefit assessment
  • compassionate use of drugs
  • ADMET of drugs

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Published Papers (5 papers)

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Editorial

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5 pages, 505 KiB  
Editorial
Post COVID-19 Reflections and Questions: How Prepared Are We for the Next Pandemic?
by George J. Kontoghiorghes, Annita Kolnagou and Christina N. Kontoghiorghe
Int. J. Mol. Sci. 2024, 25(2), 859; https://doi.org/10.3390/ijms25020859 - 10 Jan 2024
Cited by 1 | Viewed by 1227
Abstract
While the end of the COVID-19 pandemic was announced earlier in 2023 by WHO, the currently dominating COVID-19 virus variants, such as the omicron sub-lineages XBB [...] Full article
(This article belongs to the Special Issue COVID-19 Innovative Drug Treatments: Looking for the Magic Cure to End the Pandemic)
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Research

Jump to: Editorial, Review

18 pages, 997 KiB  
Article
Therapeutic Efficacy and Outcomes of Remdesivir versus Remdesivir with Tocilizumab in Severe SARS-CoV-2 Infection
by Damiana-Maria Vulturar, Maria Adriana Neag, Ștefan Cristian Vesa, Anca-Diana Maierean, Diana Gherman, Anca Dana Buzoianu, Olga Hilda Orăsan and Doina-Adina Todea
Int. J. Mol. Sci. 2022, 23(22), 14462; https://doi.org/10.3390/ijms232214462 - 21 Nov 2022
Cited by 3 | Viewed by 2028
Abstract
The infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) generated many challenges to find an effective drug combination for hospitalized patients with severe forms of coronavirus disease 2019 (COVID-19) pneumonia. We conducted a retrospective cohort study, including 182 patients with severe COVID-19 [...] Read more.
The infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) generated many challenges to find an effective drug combination for hospitalized patients with severe forms of coronavirus disease 2019 (COVID-19) pneumonia. We conducted a retrospective cohort study, including 182 patients with severe COVID-19 pneumonia hospitalized between March and October 2021 in a Pneumology Hospital from Cluj-Napoca, Romania. Among patients treated with standard of care, 100 patients received remdesivir (R group) and 82 patients received the combination of remdesivir plus tocilizumab (RT group). We compared the clinical outcomes, the inflammatory markers, superinfections, oxygen requirement, intensive care unit (ICU) admission and mortality rate before drug administration and 7 days after in R group and RT group. Borg score and oxygen support showed an improvement in the R group (p < 0.005). Neutrophiles, C-reactive protein (CRP) and serum ferritin levels decreased significantly in RT group but with a higher rate of superinfection in this group. ICU admission and death did not differ significantly between groups. The combination of remdesivir plus tocilizumab led to a significantly improvement in the inflammatory markers and a decrease in the oxygen requirement. Although the superinfection rate was higher in RT group than in R group, no significant difference was found in the ICU admission and mortality rate between the groups. Full article
(This article belongs to the Special Issue COVID-19 Innovative Drug Treatments: Looking for the Magic Cure to End the Pandemic)
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21 pages, 15275 KiB  
Article
Reconstructed Genome-Scale Metabolic Model Characterizes Adaptive Metabolic Flux Changes in Peripheral Blood Mononuclear Cells in Severe COVID-19 Patients
by Hao Tang, Yanguang Liu, Yao Ruan, Lingqiao Ge and Qingye Zhang
Int. J. Mol. Sci. 2022, 23(20), 12400; https://doi.org/10.3390/ijms232012400 - 17 Oct 2022
Cited by 2 | Viewed by 2327
Abstract
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) poses a mortal threat to human health. The elucidation of the relationship between peripheral immune cells and the development of inflammation is essential for revealing the pathogenic mechanism of COVID-19 and [...] Read more.
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) poses a mortal threat to human health. The elucidation of the relationship between peripheral immune cells and the development of inflammation is essential for revealing the pathogenic mechanism of COVID-19 and developing related antiviral drugs. The immune cell metabolism-targeting therapies exhibit a desirable anti-inflammatory effect in some treatment cases. In this study, based on differentially expressed gene (DEG) analysis, a genome-scale metabolic model (GSMM) was reconstructed by integrating transcriptome data to characterize the adaptive metabolic changes in peripheral blood mononuclear cells (PBMCs) in severe COVID-19 patients. Differential flux analysis revealed that metabolic changes such as enhanced aerobic glycolysis, impaired oxidative phosphorylation, fluctuating biogenesis of lipids, vitamins (folate and retinol), and nucleotides played important roles in the inflammation adaptation of PBMCs. Moreover, the main metabolic enzymes such as the solute carrier (SLC) family 2 member 3 (SLC2A3) and fatty acid synthase (FASN), responsible for the reactions with large differential fluxes, were identified as potential therapeutic targets. Our results revealed the inflammation regulation potentials of partial metabolic reactions with differential fluxes and their metabolites. This study provides a reference for developing potential PBMC metabolism-targeting therapy strategies against COVID-19. Full article
(This article belongs to the Special Issue COVID-19 Innovative Drug Treatments: Looking for the Magic Cure to End the Pandemic)
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12 pages, 2055 KiB  
Article
A Study of Drug Repurposing to Identify SARS-CoV-2 Main Protease (3CLpro) Inhibitors
by Seri Jo, Luca Signorile, Suwon Kim, Mi-Sun Kim, Oscar Huertas, Raúl Insa, Núria Reig and Dong Hae Shin
Int. J. Mol. Sci. 2022, 23(12), 6468; https://doi.org/10.3390/ijms23126468 - 9 Jun 2022
Cited by 3 | Viewed by 2553
Abstract
The outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) wreaked havoc all over the world. Although vaccines for the disease have recently become available and started to be administered to the population in various countries, there [...] Read more.
The outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) wreaked havoc all over the world. Although vaccines for the disease have recently become available and started to be administered to the population in various countries, there is still a strong and urgent need for treatments to cure COVID-19. One of the safest and fastest strategies is represented by drug repurposing (DRPx). In this study, thirty compounds with known safety profiles were identified from a chemical library of Phase II-and-up compounds through a combination of SOM Biotech’s Artificial Intelligence (AI) technology, SOMAIPRO, and in silico docking calculations with third-party software. The selected compounds were then tested in vitro for inhibitory activity against SARS-CoV-2 main protease (3CLpro or Mpro). Of the thirty compounds, three (cynarine, eravacycline, and prexasertib) displayed strong inhibitory activity against SARS-CoV-2 3CLpro. VeroE6 cells infected with SARS-CoV-2 were used to find the cell protection capability of each candidate. Among the three compounds, only eravacycline showed potential antiviral activities with no significant cytotoxicity. A further study is planned for pre-clinical trials. Full article
(This article belongs to the Special Issue COVID-19 Innovative Drug Treatments: Looking for the Magic Cure to End the Pandemic)
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Review

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22 pages, 1348 KiB  
Review
Newly Emerged Antiviral Strategies for SARS-CoV-2: From Deciphering Viral Protein Structural Function to the Development of Vaccines, Antibodies, and Small Molecules
by Chunye Zhang and Ming Yang
Int. J. Mol. Sci. 2022, 23(11), 6083; https://doi.org/10.3390/ijms23116083 - 29 May 2022
Cited by 10 | Viewed by 4069
Abstract
Coronavirus disease 2019 (COVID-19) caused by the infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become the most severe health crisis, causing extraordinary economic disruption worldwide. SARS-CoV-2 is a single-stranded RNA-enveloped virus. The process of viral replication and particle packaging is [...] Read more.
Coronavirus disease 2019 (COVID-19) caused by the infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become the most severe health crisis, causing extraordinary economic disruption worldwide. SARS-CoV-2 is a single-stranded RNA-enveloped virus. The process of viral replication and particle packaging is finished in host cells. Viral proteins, including both structural and nonstructural proteins, play important roles in the viral life cycle, which also provides the targets of treatment. Therefore, a better understanding of the structural function of virus proteins is crucial to speed up the development of vaccines and therapeutic strategies. Currently, the structure and function of proteins encoded by the SARS-CoV-2 genome are reviewed by several studies. However, most of them are based on the analysis of SARS-CoV-1 particles, lacking a systematic review update for SARS-CoV-2. Here, we specifically focus on the structure and function of proteins encoded by SARS-CoV-2. Viral proteins that contribute to COVID-19 infection and disease pathogenesis are reviewed according to the most recent research findings. The structure-function correlation of viral proteins provides a fundamental rationale for vaccine development and targeted therapy. Then, current antiviral vaccines are updated, such as inactive viral vaccines and protein-based vaccines and DNA, mRNA, and circular RNA vaccines. A summary of other therapeutic options is also reviewed, including monoclonal antibodies such as a cross-neutralizer antibody, a constructed cobinding antibody, a dual functional monoclonal antibody, an antibody cocktail, and an engineered bispecific antibody, as well as peptide-based inhibitors, chemical compounds, and clustered regularly interspaced short palindromic repeats (CRISPR) exploration. Overall, viral proteins and their functions provide the basis for targeted therapy and vaccine development. Full article
(This article belongs to the Special Issue COVID-19 Innovative Drug Treatments: Looking for the Magic Cure to End the Pandemic)
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