COVID-19: discovery, diagnostics and drug development

 

Scientists propose to provide insights on the discovery of SARS-CoV-2, its virology, the diagnostic tools, and the ongoing drug discovery effort, reports the Journal of Hepatology.

 

            Amsterdam, September, 2020

The World Health Organization (WHO) announced on March 11th 2020, that the outbreak of “COronaVIrus Disease 2019” (COVID-19), which initially started in Asia, has become pandemic. On September 4th 2020 the etiologic agent “Severe Acute Respiratory Syndrome (SARS)-CoV-2 has spread all over the world with a global estimation of around 26 million confirmed cases and around 865,000 deaths [1]. The rapid availability of the virus RNA genome sequence was instrumental in the development of diagnostic tools and for the identification of experimental treatments. In this review, scientists clarify aspects related to the discovery of SARS-CoV-2, virological features, diagnostic tools, complex pathogenesis, including a focus on the liver and gastro-intestinal lesions, and of course drug discovery.

 

Key points regarding drug development:

  • Drug repurposing is a strategy for identifying new uses for approved or investigational drugs that are outside the scope of the original medical indication. This strategy has been used to rapidly identify treatment for the COVID-19 infection that could move quickly to phase-3.
  • To date, with the exception of intravenous Remdesivir or dexamethasone which have a modest effect, but significant on severe Covid-19, no strong clinical evidence supports the efficacy and safety of any drug against SARS-CoV-2.
  • Better knowledge of the virus, its enzymes, and immune response will be mandatory to develop direct-acting antiviral agents and effective vaccines.
  • A vaccine to prevent infection would be crucial to obtain, however even if 50% effective or more, the immunological protection might not persist and it may not be available before 2021 if at all.

 

Key points regarding diagnosis and prevention:

  • A Test and Trace programs will be essential. Later, “Test, Trace and Treat (T3)” programs will become mandatory once effective drugs would have been identified and safe therapies developed.
  • It will be important to precise how transmissible and pathogenic is SARS-CoV-2 in the ongoing and future epidemic. Furthermore, it will be important to improve diagnostic tools. Ideally a single or combined test that provides virological and serological output would be ideal.
  • In many countries, at the end of containment, strict recommended measures will be important to avoid new waves of contamination. However, few innovative treatment modalities have been discovered since the bulk of the effort to date has been focused on a vaccine.
  • Vaccines might not be enough to quell this pandemic. Although a large number of repurposed drug trials are being evaluated, many are redundant and lack a strong rationale to warrant clinical development. There is a small chance that some trials could grind to a halt, simply because the pandemic has been well controlled by lockdowns and other measures. 
  • However, the risks of epidemics of coronavirus remain clear and present and it is imperative that the work continues to develop vaccines and effective drugs for coronaviruses to prevent future social and economic hardships globally.

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