COVID -19 disease (Coronavirus) is a contemporary strain of coronavirus species which has initially appeared in Wuhan city, China. Over the few months it has spread to various regions of the world. It is observed that COVID-19 is able to get transmitted from human to human contact, by means of droplets sustained in the air as aerosols, fomites etc. WHO (World Health Organization) has declared the current outbreak to be a public health emergency globally. As the disease is life threatening, there is a crucial need for effective drugs. Optimistic nurture remains the backbone of the therapy. Despite the COVID-19 patients having benign or mild courses, up to 5% –10% can have serious; probably life alarming courses, there is a crucial need for effective drugs. There have been several clinical trials persisting, various immune regulating and antiviral agents for assessments of COVID-19 in those investigations and some of them would be reported in later couple of days. Although the critical need to find an efficient antiviral medication for COVID-19 through randomized controlled investigation, certain agents are being utilized all over the world, established on either envisioned evidence, in vitro or experimental studies. Presently, the research investigation on SARS COVID-2 is in the initial stages. Based on ongoing published information, this review article consistently summarizes the pathological analysis, clinical symptoms, prevention and treatment of COVID-19. Generally, maximum used therapeutic agents in India and all over the world includes hydroxychloroquine, chloroquine, remdesivir, favipiravir, lopinavir and Nitazoxanide. This review reports about Ivermectin to have an activity against SARS-COVID-19 in vitro, which is permitted for some other treatments of human diseases. It is assumed that this review will encourage the nation to recognize and handle COVID-19 and contribute for prospective studies.

Reference

1.       Center for disease control and prevention. Coronavirus disease 2019(COVID-19) - Situation Summary; 2020 [cited Mar 11 2020]. Available from: https://www.cdc.gov/coronavirus/2019ncov/summary.html.

2.       WHO. Corona virus disease 2019 (COVID −19) Situation [report]-55 USA: World Health Organization (WHO) [cited Mar 15 2020]. Available from: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200315-sitrep-55-covid-19.pdf?sfvrsn=33daa5cb_8; 2020.

3.       WHO. Clinical management of severe acute respiratory infection when novel coronavirus [nCoV] infection is suspected; 2020 [cited Feb 9 2020]. Available from: https://www.who.int/publications-detail/clinical-management-of-severe-acute-respiratory-infection-when-novel coronavirus-[ncov]-infection-is-suspected.

4.       Wang C, Horby PW, Hayden FG, Gao GF. A novel coronavirus outbreak of global health concern. Lancet. 2020;395(10223):470-3. doi: 10.1016/S0140-6736(20)30185-9, PMID 31986257.

5.       Heidary F, Gharebaghi R. Ivermectin: a systematic review from antiviral effects to COVID-19 complementary regimen. J Antibiot. 2020;73(9):593-602. doi: 10.1038/s41429-020-0336-z, PMID 32533071.

6.       Chen Y, Liu Q, Guo D. Emerging corona viruses: genome structure, replication, and pathogenesis. J Med Virol. 2020;92(4):418-23. doi: 10.1002/jmv.25681, PMID 31967327.

7.       Zhu N, Zhang D, Wang W et al. A novel corona virus from patients with pneumonia in China. 2019 N. Engl. J Med. 2020;38:727-33.

8.       Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, Qiu Y, Wang J, Liu Y, Wei Y, Xia J, Yu T, Zhang X, Zhang L. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-13. doi: 10.1016/S0140-6736(20)30211-7, PMID 32007143.

9.       Centers for Disease Control and Prevention. Human Corona virus types; 2020 [cited Mar 11 2020]. Available from: https://www.cdc.gov/coronavirus/types.html.

10.     Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, Wang W, Song H, Huang B, Zhu N, Bi Y, Ma X, Zhan F, Wang L, Hu T, Zhou H, Hu Z, Zhou W, Zhao L, Chen J, Meng Y, Wang J, Lin Y, Yuan J, Xie Z, Ma J, Liu WJ, Wang D, Xu W, Holmes EC, Gao GF, Wu G, Chen W, Shi W, Tan W. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet. 2020;395(10224):565-74. doi: 10.1016/S0140-6736(20)30251-8, PMID 32007145.

11.     Centers for Disease Control and Prevention. How COVID-19 spreads; 2020 [cited Mar 11 2020]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/about/transmission.html.

12.     Talaiekhozani A. A short communication on COVID-19 Outbreak. J Infertil Reprod Biol. 2019;7(4):27-8.

13.     Xinhuanet. Novel corona virus can transmit via aerosol: health authorities. China: Xinhuanet; 2020.

14.     Manson RJ. Pathogenesis of COVID-19 from a cell biology perspective. Eur Respir J. 2020;55. ; DOI: 10.1183/13993003.00607-2020.

15.     McCreary EK, Pogue JM. Coronavirus Disease 2019 treatment: a review of early and emerging options. Open Forum Infect Dis. 2020;7(4):ofaa105. doi: 10.1093/ofid/ofaa105, PMID 32284951.

16.     Uyeki TM, Bernstein HH, Bradley JS, Englund JA, File TM. Clinical practice guidelines by the infectious diseases society of America: 2018 update on diagnosis, treatment, chemoprophylaxis, and institutional outbreak management of seasonal influenza. Clin Infect Dis. 2019;68.

17.     Gautret P, Lagier JC, Parola P, Hoang VT, Meddeb L, Sevestre J, Mailhe M, Doudier B, Aubry C, Amrane S, Seng P, Hocquart M, Eldin C, Finance J, Vieira VE, Tissot-Dupont HT, Honoré S, Stein A, Million M, Colson P, La Scola B, Veit V, Jacquier A, Deharo JC, Drancourt M, Fournier PE, Rolain JM, Brouqui P, Raoult D. Clinical and microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up: A pilot observational study. Travel Med Infect Dis. 2020;34:101663. doi: 10.1016/j.tmaid.2020.101663, PMID 32289548.

18.     ?im?ek Yavuz S, Ünal S. Antiviral treatment of COVID-19. Turk J Med Sci. 2020;50(SI-1):611-9. doi: 10.3906/sag-2004-145, PMID 32293834.

19.     Götz V, Magar L, Dornfeld D, Giese S, Pohlmann A, Höper D, Kong BW, Jans DA, Beer M, Haller O, Schwemmle M. Influenza A viruses escape from MxA restriction at the expense of efficient nuclear vRNP import [Sci Rep:23138]. Sci Rep. 2016;6:23138. doi: 10.1038/srep23138, PMID 26988202.

20.     Buonfrate D, Salas-Coronas J, Muñoz J, Maruri BT, Rodari P, Castelli F, Zammarchi L, Bianchi L, Gobbi F, Cabezas-Fernández T, Requena-Mendez A, Godbole G, Silva R, Romero M, Chiodini PL, Bisoffi Z. Multiple-dose versus single-dose ivermectin for Strongyloides stercoralis infection (Strong Treat 1 to 4): a multicentre, open-label, phase 3, randomised controlled superiority trial. Lancet Infect Dis. 2019;19(11):1181-90. doi: 10.1016/S1473-3099(19)30289-0, PMID 31558376.

21.     Tay MY, Fraser JE, Chan WK, Moreland NJ, Rathore AP, Wang C, Vasudevan SG, Jans DA. Nuclear localization of dengue virus (DENV) 1-4 non-structural protein 5; protection against all 4 DENV serotypes by the inhibitor ivermectin. Antiviral Res. 2013;99(3):301-6. doi: 10.1016/j.antiviral.2013.06.002, PMID 23769930.

22.     Yang SNY, Atkinson SC, Wang C, Lee A, Bogoyevitch MA, Borg NA, Jans DA. The broad spectrum antiviral ivermectin targets the host nuclear transport importin α/β1 heterodimer. Antiviral Res. 2020;177:104760. doi: 10.1016/j.antiviral.2020.104760.

23.     Lv C, Liu W, Wang B, Dang R, Qiu L, Ren J, Yan C, Yang Z, Wang X. Ivermectin inhibits DNA polymerase UL42 of pseudorabies virus entrance into the nucleus and proliferation of the virus in vitro and vivo. Antiviral Res. 2018;159:55-62. doi: 10.1016/j.antiviral.2018.09.010, PMID 30266338.

24.     Wagstaff KM, Sivakumaran H, Heaton SM, Harrich D, Jans DA. Ivermectin is a specific inhibitor of importin α/β-mediated nuclear import able to inhibit replication of HIV-1 and dengue virus. Biochem J. 2012;443(3):851-6. doi: 10.1042/BJ20120150, PMID 22417684.

25.     Lundberg L, Pinkham C, Baer A, Amaya M, Narayanan A, Wagstaff KM, Jans DA, Kehn-Hall K. Nuclear import and export inhibitors alter capsid protein distribution in mammalian cells and reduce Venezuelan equine encephalitis virus replication. Antiviral Res. 2013;100(3):662-72. doi: 10.1016/j.antiviral.2013.10.004, PMID 24161512.

26.     Dong L, Hu S, Gao J. Discovering drugs to treat corona virus disease 2019 (COVID-19). Drug Discov Ther. 2020;14(1):58-60. doi: 10.5582/ddt.2020.01012, PMID 32147628.

27.     Jans DA, Martin AJ, Wagstaff KM. Inhibitors of nuclear transport. Curr Opin Cell Biol. 2019;58:50-60. doi: 10.1016/j.ceb.2019.01.001, PMID 30826604.

28.     Vora A, Arora VK, Behera D, Tripathy SK. White paper on ivermectin as a potential therapy for COVID-19. Indian J Tuberc. 2020;67(3):448-51. doi: 10.1016/j.ijtb.2020.07.031, PMID 32825892.

29.     Caly L, Druce JD, Catton MG, Jans DA, Wagstaff KM. The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro. Antiviral Res. 2020;178:104787. doi: 10.1016/j.antiviral.2020.104787.

30.     Banerjee K, Nandy M, Dalai CK, Ahmed SN. The battle against COVID 19 pandemic: what we need to know before we ”test fire” ivermectin. Drug Res (Stuttg). 2020;70(8):337-40. doi: 10.1055/a-1185-8913, PMID 32559771.

31.     Formiga FR, Leblanc R, de Souza Rebouças J, Farias LP, de Oliveira RN, Pena L. Ivermectin: an award-winning drug with expected antiviral activity against COVID-19. J Control Release. 2020 Oct 7;S0168-3659(20):30580-0. doi: 10.1016/j.jconrel.2020.10.009. PMID 33038449, PMCID PMC7539925.

32.     Guzzo CA, Furtek CI, Porras AG, Chen C, Tipping R, Clineschmidt CM, Sciberras DG, Hsieh JY, Lasseter KC. Safety, tolerability, and pharmacokinetics of escalating high doses of ivermectin in healthy adult subjects. J Clin Pharmacol. 2002;42(10):1122-33. doi: 10.1177/009127002401382731, PMID 12362927.

33.     Drugs@FDA: FDA-Approved Drugs. STROMECTOL® (ivermectin) tablets [internet] [cited Jul 19 2020]. Available from: https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event¼overview.process&ApplNo¼050742.

34.     Caly L, Druce JD, Catton MG, Jans DA, Wagstaff KM. The FDAapproved drug ivermectin inhibits the replication of SARS450 Indian journal of tuberculosis 67 (2020) 448 e451 CoV-2 in vitro. Antiviral Res. 2020;178: 104787:5. doi: 10.1016/j.antiviral.2020.104787.

35.     Vora A, Arora VK, Behera D, Tripathy SK. White paper on ivermectin as a potential therapy for COVID-19. Indian J Tuberc. 2020 [Letter to the editor];67(3):(448-51). doi: 10.1016/j.ijtb.2020.07.031, PMID 32825892.