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The Need for Antiviral Drugs for Pandemic Coronaviruses From a Global Health Perspective

Respiratory failure due to SARS-CoV-2 has caused widespread mortality, creating an urgent need for effective treatments and a long-term need for antivirals for future emergent coronaviruses. Pharmacotherapy for respiratory viruses has largely been unsuccessful with the exception of early treatment o...

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Autores principales: Villamagna, Angela Holly, Gore, Sara J., Lewis, James S., Doggett, J. Stone
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7783399/
https://www.ncbi.nlm.nih.gov/pubmed/33415116
http://dx.doi.org/10.3389/fmed.2020.596587
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author Villamagna, Angela Holly
Gore, Sara J.
Lewis, James S.
Doggett, J. Stone
author_facet Villamagna, Angela Holly
Gore, Sara J.
Lewis, James S.
Doggett, J. Stone
author_sort Villamagna, Angela Holly
collection PubMed
description Respiratory failure due to SARS-CoV-2 has caused widespread mortality, creating an urgent need for effective treatments and a long-term need for antivirals for future emergent coronaviruses. Pharmacotherapy for respiratory viruses has largely been unsuccessful with the exception of early treatment of influenza viruses, which shortens symptom duration and prevents infection in close contacts. Under the rapidly evolving circumstances of the COVID-19 pandemic, most clinical trials of experimental treatments in the United States have focused on later stages of the disease process. Worldwide, the clinical studies of the most impactful drugs, remdesivir and dexamethasone in ACTT-1, RECOVERY, and Solidarity, have studied hospitalized patients. Less than half of clinical trials in the U.S. have investigated oral agents, and the majority have taken place in hospitals at a disease stage where the viral load is already decreasing. The limited success of treatments for respiratory viruses and the viral dynamics of COVID-19 suggest that an antiviral therapy with the greatest impact against pandemic coronaviruses would be orally administered, well-tolerated, target a highly conserved viral protein or host-coronavirus interaction and could be used effectively throughout the world, including resource-poor settings. We examine the treatment of respiratory viral infections and current clinical trials for COVID-19 to provide a framework for effective antiviral therapy and prevention of future emergent coronaviruses and call attention to the need for continued preclinical drug discovery.
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spelling pubmed-77833992021-01-06 The Need for Antiviral Drugs for Pandemic Coronaviruses From a Global Health Perspective Villamagna, Angela Holly Gore, Sara J. Lewis, James S. Doggett, J. Stone Front Med (Lausanne) Medicine Respiratory failure due to SARS-CoV-2 has caused widespread mortality, creating an urgent need for effective treatments and a long-term need for antivirals for future emergent coronaviruses. Pharmacotherapy for respiratory viruses has largely been unsuccessful with the exception of early treatment of influenza viruses, which shortens symptom duration and prevents infection in close contacts. Under the rapidly evolving circumstances of the COVID-19 pandemic, most clinical trials of experimental treatments in the United States have focused on later stages of the disease process. Worldwide, the clinical studies of the most impactful drugs, remdesivir and dexamethasone in ACTT-1, RECOVERY, and Solidarity, have studied hospitalized patients. Less than half of clinical trials in the U.S. have investigated oral agents, and the majority have taken place in hospitals at a disease stage where the viral load is already decreasing. The limited success of treatments for respiratory viruses and the viral dynamics of COVID-19 suggest that an antiviral therapy with the greatest impact against pandemic coronaviruses would be orally administered, well-tolerated, target a highly conserved viral protein or host-coronavirus interaction and could be used effectively throughout the world, including resource-poor settings. We examine the treatment of respiratory viral infections and current clinical trials for COVID-19 to provide a framework for effective antiviral therapy and prevention of future emergent coronaviruses and call attention to the need for continued preclinical drug discovery. Frontiers Media S.A. 2020-12-22 /pmc/articles/PMC7783399/ /pubmed/33415116 http://dx.doi.org/10.3389/fmed.2020.596587 Text en Copyright © 2020 Villamagna, Gore, Lewis and Doggett. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Villamagna, Angela Holly
Gore, Sara J.
Lewis, James S.
Doggett, J. Stone
The Need for Antiviral Drugs for Pandemic Coronaviruses From a Global Health Perspective
title The Need for Antiviral Drugs for Pandemic Coronaviruses From a Global Health Perspective
title_full The Need for Antiviral Drugs for Pandemic Coronaviruses From a Global Health Perspective
title_fullStr The Need for Antiviral Drugs for Pandemic Coronaviruses From a Global Health Perspective
title_full_unstemmed The Need for Antiviral Drugs for Pandemic Coronaviruses From a Global Health Perspective
title_short The Need for Antiviral Drugs for Pandemic Coronaviruses From a Global Health Perspective
title_sort need for antiviral drugs for pandemic coronaviruses from a global health perspective
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7783399/
https://www.ncbi.nlm.nih.gov/pubmed/33415116
http://dx.doi.org/10.3389/fmed.2020.596587
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