COVID-19: well-known drugs, new opportunities

Up to now, coronavirus infection that causes an acute respiratory syndrome has been detected almost in all countries worldwide. Global spread of SARS-CoV-2 virus has become a world pandemic and there is no efficient and commonly accepted conventional therapy against COVID-19. Due to the existing emergency most drugs that can potentially be used to treat COVID-19 are allowed to be applied only basing on certain data probing their safety and efficiency against SARS-CoV. At present only Lopinavir/Ritonavir and Remdesivir are the only anti-virus drugs that are included into well-recognized management procedures for COVID-19 treatment; an acceptable alternative could probably be combined therapy that includes Hydroxychloroquine and Azithromycin. Given the existing situation, a lot of drugs that are usually used to treat other diseases are now being suggested as probable ways to treat COVID-19 taking into account all the available knowledge on pathophysiology of the infection. In this review, basing on available data on how SARA-CoV-2 virus enters a cell and pathophysiological aspects of cytokine storm development, we have strived to highlight certain prospects related to applying anti-viral medications, anti-inflammatory and immune-suppressing drugs, vitamins and microelements that are widely used to treat and prevent various diseases. Most tested drugs as well as zinc preparations, and vitamins С and D3 turned out to have not only immune-modulating but also anti-inflammatory properties; or either they were able to block ways for the virus to enter a cell or disrupt SARS-CoV-2 intracellular replication. Having leant from previous experience in fighting against SARS and MERS, doctors have applied some existing drugs to treat COVID-19 infections in their clinical practices; clinical tests aimed at confirming their safety and efficiency in treating COVID-19 are still being performed at the moment. Although a lot of various treatment procedures have been suggested, it is necessary to perform specifically planned randomized clinical trials based on evidence-based medicine principles, if we want to determine the most suitable ones.