key: cord-299986-wuaxatrb authors: Afsar, Nasir Ali title: The looming pandemic of COVID-19: What therapeutic options do we have now? date: 2020-04-21 journal: J Chin Med Assoc DOI: 10.1097/jcma.0000000000000310 sha: doc_id: 299986 cord_uid: wuaxatrb nan The world came to know about a new corona virus infection spreading from Wuhan, China, in December 2019. Over the following 3 months, this respiratory pathogen, named as nCoV-2019, SARS CoV-2, or Covid-19, has affected many in the most populous regions of the world and there are growing concerns about it being a pandemic. World Health Organization (WHO) has reported infection in all continents in its Situation Report-42 published on 2 March 2020 and >3000 deaths (https:// www.who.int/docs/default-source/coronaviruse/situationreports/20200302-sitrep-42-covid-19.pdf?sfvrsn=224c1add_2). Although it causes a flu-like respiratory illness, the mortality is low among previously healthy, young individuals but high in elderly and critically ill. 1 However, the low percent mortality has already transformed into a big absolute number (>3000 individuals) and counting. Each life is precious and there is a global movement to find treatment for this disease. As yet, no definite prevention or cure is available for COVID-19. Lately, some reports have surfaced about various drugs indicated for other viral illness, being tried for this disease due to existing evidence in two related disorders, SARS-CoV and MERS-CoV. To critically evaluate the existing options, an attempt has been made to list the drugs considered potentially useful in corona virus infections including the previous outbreaks of SARS and MERS and are tabulated ( Table 1) to derive lessons from the existing scientific literature. This is highly imperative that although new drug and vaccine development is in progress, existing treatment may be applied to save precious lives. The information in media that corona virus has no effective treatment has already created panic in the masses and resultant lock down in many parts of the world. Hence, it could be helpful to mitigate the impression of "no treatment" and resultant fear around the world. www.ejcma.org Afsar J Chin Med Assoc Zinc supplements may positively influence patient outcome. Wen 14 In vitro assay Chinese herbs Potential for drug development. Difficult to assign therapeutic benefit to a single agent. Effectively inhibit viral replication; may prove to be beneficial as a herbal product. IFN = interferon; MPA = mycophenolic acid. Early epidemiological analysis of the coronavirus disease 2019 outbreak based on crowdsourced data: a population level observational study Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding Case of the index patient who caused tertiary transmission of COVID-19 infection in Korea: the application of lopinavir/ritonavir for the treatment of COVID-19 infected pneumonia monitored by quantitative RT-PCR Treatment with lopinavir/ritonavir or interferon-β1b improves outcome of MERS-CoV infection in a nonhuman primate model of common marmoset Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro Prophylactic and therapeutic remdesivir (GS-5734) treatment in the rhesus macaque model of MERS-CoV infection Interferon-β and mycophenolic acid are potent inhibitors of Middle East respiratory syndrome coronavirus in cell-based assays Inhibition of novel β coronavirus replication by a combination of interferon-α2b and ribavirin Middle Eastern respiratory syndrome corona virus (MERS CoV): case reports from a tertiary care hospital in Saudi Arabia Ribavirin and interferon therapy for critically Ill patients with Middle East respiratory syndrome: a multicenter observational study Inhibition of severe acute respiratory syndrome coronavirus replication by niclosamide Corticosteroid therapy for critically Ill patients with Middle East respiratory syndrome Zinc lozenges and the common cold: a meta-analysis comparing zinc acetate and zinc gluconate, and the role of zinc dosage Traditional Chinese medicine herbal extracts of Cibotium barometz, Gentiana scabra, Dioscorea batatas, Cassia tora, and Taxillus chinensis inhibit SARS-CoV replication