Compounds with Therapeutic Potential against Novel Respiratory 2019 Coronavirus

Antimicrob Agents Chemother. 2020 Apr 21;64(5):e00399-20. doi: 10.1128/AAC.00399-20. Print 2020 Apr 21.


Currently, the expansion of the novel human respiratory coronavirus (known as SARS-CoV-2 [severe acute respiratory syndrome coronavirus 2], COVID-2019 [coronavirus disease 2019], or 2019-nCoV [2019 novel coronavirus]) has stressed the need for therapeutic alternatives to alleviate and stop this new epidemic. The previous epidemics of infections by high-morbidity human coronaviruses, such as SARS-CoV in 2003 and the Middle East respiratory syndrome coronavirus (MERS-CoV) in 2012, prompted the characterization of compounds that could be potentially active against the currently emerging novel coronavirus, SARS-CoV-2. The most promising compound is remdesivir (GS-5734), a nucleotide analog prodrug currently in clinical trials for treating Ebola virus infections. Remdesivir inhibited the replication of SARS-CoV and MERS-CoV in tissue cultures, and it displayed efficacy in nonhuman animal models. In addition, a combination of the human immunodeficiency virus type 1 (HIV-1) protease inhibitors lopinavir/ritonavir and interferon beta (LPV/RTV-IFN-β) was shown to be effective in patients infected with SARS-CoV. LPV/RTV-IFN-β also improved clinical parameters in marmosets and mice infected with MERS-CoV. Remarkably, the therapeutic efficacy of remdesivir appeared to be superior to that of LPV/RTV-IFN-β against MERS-CoV in a transgenic humanized mouse model. The relatively high mortality rates associated with these three novel human coronavirus infections, SARS-CoV, MERS-CoV, and SARS-CoV-2, have suggested that proinflammatory responses might play a role in the pathogenesis. It remains unknown whether the generated inflammatory state should be targeted. Therapeutics that target the coronavirus alone might not be able to reverse highly pathogenic infections. This minireview aims to provide a summary of therapeutic compounds that have shown potential in fighting SARS-CoV-2 infections.

Keywords: SARS-CoV-2; antiviral agents; coronavirus.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adenosine Monophosphate / analogs & derivatives*
  • Adenosine Monophosphate / therapeutic use
  • Alanine / analogs & derivatives*
  • Alanine / therapeutic use
  • Animals
  • Antibodies, Monoclonal / therapeutic use
  • Antiviral Agents / therapeutic use*
  • Betacoronavirus / drug effects
  • COVID-19
  • Clinical Trials as Topic
  • Coronavirus Infections / drug therapy*
  • Coronavirus Infections / therapy
  • Drug Combinations
  • Humans
  • Immunization, Passive
  • Interferon-beta / therapeutic use
  • Lopinavir / therapeutic use*
  • Mice, Transgenic
  • Middle East Respiratory Syndrome Coronavirus / drug effects
  • Pandemics
  • Pneumonia, Viral / drug therapy*
  • Ribavirin / therapeutic use
  • Ritonavir / therapeutic use*
  • SARS Virus / drug effects
  • SARS-CoV-2
  • Spike Glycoprotein, Coronavirus / antagonists & inhibitors


  • Antibodies, Monoclonal
  • Antiviral Agents
  • Drug Combinations
  • Spike Glycoprotein, Coronavirus
  • lopinavir-ritonavir drug combination
  • spike protein, SARS-CoV-2
  • Lopinavir
  • remdesivir
  • Adenosine Monophosphate
  • Ribavirin
  • Interferon-beta
  • Ritonavir
  • Alanine

Supplementary concepts

  • COVID-19 drug treatment
  • COVID-19 serotherapy