ritonavir and nafamostat

The ongoing SARS-CoV-2 pandemic stresses the need for effective antiviral drugs that can quickly be applied in order to reduce morbidity, mortality, and ideally viral transmission. By repurposing of broadly active antiviral drugs and compounds that are known to inhibit viral replication of related viruses, several advances could be made in the development of treatment strategies against COVID-19. The nucleoside analog remdesivir, which is known for its potent in vitro activity against Ebolavirus and other RNA viruses, was recently shown to reduce the time to recovery in patients with severe COVID-19. It is to date the only approved antiviral for treating COVID-19. Here, we provide a mechanism and evidence-based comparative review of remdesivir and other repurposed drugs with proven in vitro activity against SARS-CoV-2.

Topics: Adenosine Monophosphate; Alanine; Amides; Antiviral Agents; Benzamidines; COVID-19 Drug Treatment; Drug Repositioning; Esters; Guanidines; Guanine; Humans; Indoles; Lopinavir; Protease Inhibitors; Pyrazines; Ribavirin; Ritonavir; SARS-CoV-2; Virus Internalization; Virus Replication

The number of people infected with severe acute respiratory syndrome coronavirus 2 is increasing globally, and some patients have a fatal clinical course. In light of this situation, the World Health Organization (WHO) declared coronavirus disease 2019 (COVID-19) a pandemic on March 11, 2020. While clinical studies and basic research on a treatment for COVID-19 are ongoing around the world, no treatment has yet been proven to be effective. Several clinical studies have demonstrated the efficacy of chloroquine phosphate and nafamostat mesylate with COVID-19. Here, we report the case of a Japanese patient with COVID-19 with severe respiratory failure who improved following the administration of hydroxychloroquine and continuous hemodiafiltlation with nafamostat mesylate. Hence, hydroxychloroquine with nafamostat mesylate might be a treatment option for severe COVID-19.

Topics: Aged; Anti-Inflammatory Agents, Non-Steroidal; Antiviral Agents; Benzamidines; Betacoronavirus; Coronavirus Infections; COVID-19; COVID-19 Drug Treatment; Drug Combinations; Guanidines; Hemodiafiltration; Humans; Hydroxychloroquine; Japan; Lopinavir; Male; Pandemics; Pneumonia, Viral; Respiratory Insufficiency; Ritonavir; SARS-CoV-2; Treatment Outcome