The rationale for current pharmacotherapy of COVID-19

Severe acute respiratory syndrome (SARS-CoV), Middle East respiratory syndrome (MERS) and SARS-CoV-2 are related to the coronaviridae family. The worldwide pandemic of the new coronavirus disease 2019 (COVID-19) due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) broke out in Wuhan province of China, in December 2019, and spread rapidly throughout the world. More than 6 million cases and 370,000 deaths had been reported by 31 May 2020 in more than 200 countries. No data are available from any clinical trials supporting a proposed prophylactic therapy. More than 300 active clinical trials are currently underway. Many drugs have been studied against COVID-19, but there is no actual evidence from any randomized clinical trials with a potential therapy that can improve outcomes of a patient diagnosed with COVID-19. In some cases, many of the investigated drugs cause side effects, e.g. chloroquine, ribavirin. Besides its beneficial effects such as reducing disease progression and decreasing symptom duration, chloroquine can cause cardiac side effects. Ribavirin, on the other hand, is recognized as a teratogen and considered unsafe in pregnancy. No special effective antiviral therapy against COVID-19 is currently available. Although the course of the disease is mild and moderate in the majority of the COVID-19 patients, more than 5%-7% of the patients' life being under severely susceptible threats requires more effective medicinal products, urgently.