Scoping Insight on Antiviral Drugs Against COVID-19

Ali, Ahmed S; Ibrahim, Ibrahim M; Burzangi, Abdulhadi S; Ghoneim, Ragia H.; Aljohani, Hanin S; Alsamhan, Hamoud A; Barakat, Jehan

Background COVID-19 is an ongoing viral pandemic produced by SARS-CoV-2. In light of in vitro efficacy, several medications were repurposed for its management. During clinical use, many of these medications produced inconsistent results or had varying limitations. Objective The purpose of this literature review is to explain the variable efficacy or limitations of Lopinavir/Ritonavir, Remdesivir, Hydroxychloroquine, and Favipiravir in clinical settings. Method A study of the literature on the pharmacodynamics (PD), pharmacokinetics (PK), safety profile, and clinical trials through academic databases using relevant search terms. Results & Discussion The efficacy of an antiviral drug against COVID-19 is associated with its ability to achieve therapeutic concentration in the lung and intestinal tissues. This efficacy depends on the PK properties, particularly protein binding, volume of distribution, and half-life. The PK and PD of the model drugs need to be integrated to predict their limitations. Conclusion Current antiviral drugs have varying pharmacological constraints that may associate with limited efficacy, especially in severe COVID-19 patients, or safety concerns. Disclaimer What was mentioned in this paper is a scientific view and information relating to general principles which should not be construed as specific instructions to change or criticize any protocols. But rather an academic discussion to push further research and development of these drugs for better achievements.