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COVID-19: Prevention & Investigational Treatments

Other names: 2019 Novel Coronavirus; 2019-nCoV; Coronavirus; Novel Coronavirus Pneumonia; SARS-CoV-2 Infection

Updated - November 24, 2021. J.Stewart BPharm

What is COVID-19?

COVID-19 is the disease caused by an infection of the SARS-CoV-2 virus, first identified in the city of Wuhan, in China's Hubei province in December 2019. COVID-19 was previously known as 2019 Novel Coronavirus (2019-nCoV) respiratory disease before the World Health Organization (WHO) declared the official name as COVID-19 in February 2020.

The SARS-CoV-2 virus belongs to the family of viruses called coronaviruses, which also includes the viruses that cause the common cold, and the viruses that cause more serious infections such as severe acute respiratory syndrome (SARS), which was caused by SARS-CoV in 2002, and Middle East respiratory syndrome (MERS), which was caused by MERS-CoV in 2012. Like the other coronaviruses, the SARS-CoV-2 virus primarily causes respiratory tract infections, and the severity of the COVID-19 disease can range from mild to fatal.

For more information on COVID-19 Symptoms, Prevention and Risks

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FDA approved COVID-19 Vaccines

  • Comirnaty (COVID-19 Vaccine, mRNA)
    Vaccine platform: mRNA vaccine
    FDA approval date:  August 23, 2021
    Comirnaty vaccine is FDA approved to prevent coronavirus disease 2019 (COVID-19) in patients 16 years and older.
    It is a nucleoside-modified messenger RNA (modRNA) that encodes the viral spike (S) glycoprotein of SARS-CoV-2.
    Comirnaty vaccine has Emergency Use Authorization for a 2 dose primary series for individuals 12 through to 15 years of age, and it can be used as a third primary series dose for individuals who are 12 years and older and are specifically immunocompromised.
    Comirnaty vaccine EUA was amended on November 19, 2021 for a single booster for individuals who are 18 years of age or older and have completed the primary series of Comirnaty, Pfizer-BioNTech vaccine or another authorized COVID-19 vaccine.
    Comirnaty contains the same vaccine as Pfizer-bioNTech COVID-19.
    The FDA approved vaccine has the brand name Comirnaty, and when it is used under an Emergency Use Authorization (EUA) approval it has the name Pfizer-bioNTech COVID-19.
    Company: Pfizer Inc. and BioNTech


COVID-19 Vaccines Available Under FDA Emergency Use Authorization (EUA)

  • Pfizer-BioNTech COVID-19 Vaccine (BNT162b2)
    Vaccine platform: mRNA vaccine
    BNT162b2 is a nucleoside-modified messenger RNA (modRNA) that encodes the viral spike (S) glycoprotein of SARS-CoV-2.
    Pfizer-BioNTech COVID-19 Vaccine is available under Emergency Use Authorization for individuals 5 years and older, as a 2 dose series given 3 weeks apart.
    Children 5 to 11 years of age received FDA Emergency Use Authorization on October 29, 2021.
    Adolescents 12 to 15 years of age received FDA Emergency Use Authorization on May 10, 2021.
    Patients 16 years and older are able use the FDA approved vaccine Comirnaty.
    Immunocompromised patients 12 years and older, who fit the criteria, may have a third primary series dose given 28 days after the second dose.
    Pfizer-BioNTech COVID-19 vaccine EUA was amended on November 19, 2021 for a single booster for individuals who are 18 years of age or older and have completed the primary series of Pfizer-BioNTech vaccine, Comirnaty or another authorized COVID-19 vaccine.
    Pfizer-BioNTech COVID-19 contains the same vaccine as Comirnaty.
    When the vaccine is used under an EUA approval it has the name Pfizer-bioNTech COVID-19 and when it is used as a FDA approved medicine it has the brand name Comirnaty.
  • Moderna COVID-19 Vaccine (mRNA-1273)
    Vaccine platform: mRNA vaccine
    mRNA-1273 is an mRNA vaccine that encodes for a prefusion stabilized form of the Spike (S) protein of SARS-CoV-2. The FDA granted Emergency Use Authorization (EUA) for mRNA-1273 on December 18, 2020 for active immunization to prevent COVID-19 caused by SARS-CoV-2 in individuals 18 years of age and older. It is usually given as a 0.5 mL 2 doses series, given 28 days apart.
    Moderately to severely immunocompromised patients may receive a third primary series dose of 0.5 mL given 28 days after the second dose.
    The FDA Emergency Use Authorization was amended on November 19, 2021 to allow a single booster dose of 0.25mL to be given at least 6 months after finishing the primary series, for people 18 years of age and older.
    A Moderna COVID-19 Vaccine booster dose may be given following the completion of the primary vaccination series of another authorized or approved COVID-19 vaccine.
     
  • Janssen - Johnson & Johnson COVID-19 Vaccine (Ad26.COV2-S)
    Vaccine platform: Non-Replicating Viral Vector
    Ad26.COV2-S is composed of a recombinant, replication-incompetent human adenovirus type 26 vector that expresses the SARS-CoV-2 spike (S) antigen to elicit an immune response and protect against COVID-19. The FDA granted Emergency Use Authorization (EUA) for Ad26.COV2-S on February 27, 2021 for active immunization to prevent COVID-19 caused by SARS-CoV-2 in individuals 18 years of age and older. It is given as a single-dose primary regime.
    A single booster dose received FDA Emergency Use Authorization on September 22, 2021, which is given at least 2 months after other primary dose, for people 65 years of age and older, and individuals 18 through 64 years of age at high risk of severe COVID-19; and individuals 18 through 64 years of age whose frequent institutional or occupational exposure to SARS-CoV-2 puts them at high risk of serious complications of COVID-19 including severe COVID-19.

 

Treatments

  • Remdesivir (Veklury) is an FDA approved treatment for hospitalized COVID-19 patients 12 years of age and older, who weigh at least 40 kg.
    Remdesivir has an Emergency Use Authorization (amendment date August 28,2020) for treatment of hospitalized COVID-19 patients who are less than 12 years old and who weigh at least 3.5 kg.
    Remdesivir is an antiviral drug with broad-spectrum antiviral activity.
  • Bamlanivimab (LY-CoV555) is a recombinant, neutralizing human IgG1 monoclonal antibody (mAb) directed against the spike protein of SARS-CoV-2.
    Bamlanivimab is no longer authorized to be used as a monotherapy, to treat recently diagnosed COVID-19, after the FDA Emergency Use Authorization (EUA) was revoked on April 16, 2021.
    A combination therapy consisting of bamlanivimab and etesevimab (see below) is now available. Bamlanivimab and etesevimab has two separate Emergency Use Authorizations, one for the treatment of COVID-19 and another for post-exposure prophylaxis.
  • Baricitinib can be used to treat COVID-19 under the most recent amendment of the Emergency Use Authorization (EUA) from the FDA on July 28, 2021.
    It can be used for the treatment of COVID-19 in hospitalized adults and pediatric patients two years of age or older requiring supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ECMO). Previous EUA required that Baricitinib had to be used with remdesivir (Veklury) but this requirement has been revoked and it can now be used without remdesivir.
    Baricitinib is Janus kinase (JAK) inhibitor
    Baricitinib is marketed under the brand name Olumiant for the treatment of rheumatoid arthritis.
  • Casirivimab and Imdevimab (REGEN-COV) was granted FDA Emergency Use Authorization on November 21, 2020 for the treatment of mild to moderate COVID-19 in patients.  They must be at high risk for progression to severe COVID-19 and must be 12 years or older and weigh at least 40kg. The EUA was expanded  so that REGEN-COV could be used as post-exposure prophylaxis in patients who are at high risk of severe COVID-19.
  • Bamlanivimab and Etesevimab is a combination therapy that has been authorized by an amendment (issued 16 September 2021) to the Emergency Use Authorization (EUA) (issued 9 February 2021), to be used as post-exposure prophylaxis (prevention) of COVID-19 in adults and children aged 12 years and older (children must weigh at least 40 kg), who are at a high risk of developing severe COVID-19, including hospitalization or death.
    Bamlanivimab and Etesevimab is also authorized for COVID-19 treatment in some states in the US, by an amendment to the EUA issued by the FDA on August 27, 2021. Bamlanivimab and Etesevimab can be used for the treatment of mild to moderate COVID-19 in adults and patients 12 years of age and older, who weigh at least 40 kg. They must have a positive test result of SARS-CoV-2 and be at high risk for progression to severe COVID-19, including hospitalization or death. Bamlanivimab and Etesevimab can only be used in some states, territories and U.S. jurisdictions, where the combined frequency of variants that are resistant to the multidrug treatment of bamlanivimab and etesevimab is 5% or less.
    Bamlanivimab and Etesevimab is a combination of two monoclonal antibodies that work to block the infectivity of the SARS-CoV-2 virus.
  • Sotrovimab was granted Emergency Use Authorization on May 26, 2021 for the treatment of mild to moderate COVID-19, in patients who are at high risk for progression to severe COVID-19.  It should NOT be used by patients who are hospitalized due to COVID-19 or require oxygen.
    It is a monoclonal antibody designed to block SARS-CoV-2 viral entry into healthy cells and clear infected cells.
  • Tocilizumab (Actemra) was granted Emergency Use Authorization on June 24, 2021 for the treatment of COVID-19 in hospitalized patients 2 years of age and older. They must be on a specified treatment regime in hospital. Actemra is FDA approved for the treatment of rheumatoid arthritis and other inflammatory conditions.  Actemra is an interleukin-6 receptor antagonist.

 

Investigational Treatments

  • AZD7442 (Evusheld): Is a long-acting antibody (LAAB) combination of two monoclonal antibodies (tixagevimab and cilgavimab) that is being used in clinical studies for COVID-19. The studies are now at the stage of having a rolling review on preliminary results and data is being evaluated.
  • Bemcentinib: An AXL kinase inhibitor called bemcentinib has been fast-tracked in a UK Phase II clinical trial to study its effectiveness in the treatment of hospitalized patients with COVID-19. Bemcentinib has previously been studied in cancer patients and has been shown to be safe and well-tolerated. It has also been reported to exhibit potent antiviral activity in preclinical models against several enveloped viruses, including Ebola and Zika virus, and recent data have expanded this to include SARS-CoV-2.
  • Bevacizumab: A VEGF inhibitor called bevacizumab (marketed under the brand name Avastin for certain types of cancer) being studied as a treatment for acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) in critically ill patients with COVID-19. Early studies show an improvement of oxygenation and shortening of duration of oxygen-support, but more randomized controlled trials are warranted.
  • Chloroquine phosphate: The older anti-malaria drug chloroquine was studied for effectiveness for COVID-19 but scientific data showed that chloroquine was unlikely to be effective for COVID-19 and also caused serious adverse effects. For these reasons on June 15, 2020 the FDA revoked the emergency use authorization (EUA) that had allowed chloroquine phosphate to be used for covid-19 patients.
  • Colchicine: An older anti-inflammatory drug called colchicine is being studied to prevent complications of COVID-19 in high risk patients. Colchicine has long been used in the treatment of gout.
  • Convalescent Plasma: On August 23, 2020, the FDA issued an emergency use authorization (EUA) for investigational convalescent plasma for the treatment of COVID-19. Studies have been completed with varying results, including the clinical trial SIREN-C3PO  (NCT04355767) which showed convalescent plasma did not prevent disease progression of COVID-19. Another clinical trial NCT04338360 for hospitalized COVID-19 patients who were not receiving mechanical ventilation showed convalescent plasma transfusion with higher anti–SARS-CoV-2 IgG antibody levels lowered the risk of death compared to patients given convalescent plasma with lower levels of anti–SARS-CoV-2 IgG antibody levels.
  • Dexamethasone: Results of the RECOVERY clinical trial (NCT04381936) showed that the cheap and widely available steroid dexamethasone reduced the 28-day mortality in hospitalized COVID-19 patients who were receiving respiratory support. The NIH COVID-19 treatment guideline lists dexamethasone as a treatment for hospitalized adult COVID-19 on oxygen support. The trial also showed that there was no benefit and in fact may possibly cause harm to COVID-19 patients who did not require oxygen. 
  • Favipiravir: (FabiFlu®) An antiviral drug called favipiravir which was reported February 17, 2020 to have received marketing approval in China for the treatment of influenza, was also approved for use in clinical trials as a treatment for novel coronavirus pneumonia. On March 31, 2020, Fujifilm announced the start of a Phase 3 clinical trial of Avigan (favipiravir) on COVID-19 patients in Japan. Avigan is approved in Japan for use as an antiviral in the treatment of influenza. On April 9, 2020 -- Fujifilm announced the start of a Phase 2 clinical trial of favipiravir in approximately 50 COVID-19 patients in the U.S. On June 19, 2020, Glenmark Pharmaceuticals Limited announced the marketing approval of favipiravir (FabiFlu®) for the treatment of mild to moderate COVID-19 patients in India.
  • Fluvoxamine: The selective serotonin reuptake inhibitor (SSRI) antidepressant fluvoxamine may work to prevent serious illness in COVID-19 patients who aren't yet hospitalized according to a small study. The current National Institutes of Health (NIH) COVID-19 treatment guidelines report that there is still insufficient evidence either for or against the use of fluvoxamine for the treatment of COVID-19.
  • Hydroxychloroquine and azithromycin: The results of large, randomized controlled trials have failed to show a benefit using a combination of the anti-malaria drug hydroxychloroquine and the macrolide antibacterial drug azithromycin (Zithromax) to treat COVID-19.
    The National Institutes of Health (NIH) recommends against the use of hydroxychloroquine and azithromycin for COVID-19.
  • Hydroxychloroquine sulfate: Early COVID-19  reported in the journal Clinical Infectious Diseases on March 9 that the malaria drug hydroxychloroquine was effective in killing the coronavirus in laboratory experiments. However further scientific data showed hydroxychloroquine was unlikely to be effective for COVID-19 and also caused serious adverse effects. The emergency use authorization (EUA) that had been issued by the US FDA  in March 2020 to allow the emergency use of hydroxychloroquine sulfate for the treatment of COVID-19 in certain hospitalized patients, was revoked on June 15, 2020.
    The National Institutes of Health (NIH) recommends against the use of hydroxychloroquine for COVID-19.
    Hydroxychloroquine was first approved by the FDA in 1995 under the brand name Plaquenil, and it is used in the treatment of patients with lupus and arthritis.
  • Ivermectin: An anti-parasitic drug called ivermectin is currently being investigated as a treatment for coronavirus SARS-CoV-2, which is the virus that causes COVID-19. The FDA has not approved ivermectin for use in treating or preventing COVID-19 in humans. The World Health Organization (WHO) recommend not to use ivermectin in patients with COVID-19, except in clinical trials.
  • Lagevrio® (molnupiravir, MK-4482) is an oral antiviral medicine that is a potent ribonucleoside analog that inhibits the replication of SARS-CoV-2, the causative agent of COVID-19. It is used for the treatment of mild-to-moderate COVID-19 in adults who are at risk developing severe illness. MSD (Merck) announced on October 11, 2021 its application with the US FDA for Emergency Use Authorization (EUA) based on positive results from an interim analysis from the Phase 3 MOVe-OUT clinical trial.
  • Leronlimab: A CCR5 antagonist called leronlimab has shown promise in calming the 'cytokine storm' in a small number of critically ill COVID-19 patients hospitalized in the New York area.
  • Lopinavir and ritonavir: A drug combination of lopinavir with ritonavir has been studied as a treatment for COVID-19 in a number of large, randomized controlled trials, with the results showing a lack of clinical benefit. The Randomised Evaluation of COVID-19 Therapy (RECOVERY) trial using lopinavir with ritonavir was discontinued after the data showed no decrease in mortality and similar lengths of hospital stay times.  The NIH recommends against using lopinavir with ritonavir for hospitalized or non hospitalized patients.
  • Methylprednisolone: A widely used glucocorticoid called methylprednisolone is being studied for safety and effectiveness in the treatment of hospitalized COVID-19 patients. Methylprednisolone is used in severe COVID-10 for its anti-inflammatory effect as it reduces the systemic inflammatory response that leads to lung injury and multisystem organ dysfunction.  The NIH COVID-19 treatment guidelines  indicate methylprednisolone can be used if dexamethasone is unavailable. Clinical trial results comparing treatment with dexamethasone to methylprednisolone in hospitalized patients with severe SARS-CoV2 Pneumonia showed both statistically significantly reduced recovery time and the need for transfer to intensive care.
  • MK-7110 (formerly CD24Fc): is a potentially first-in-class investigational recombinant fusion protein. In April 2021, Merck announced the discontinuation of the development of MK-7110 and instead focus its pandemic efforts on advancing molnupiravir and on producing Johnson & Johnson’s COVID-19 vaccine. MK-7110 works by modulating the inflammatory response to SARS-CoV-2, principally by targeting a novel immune pathway checkpoint. Interim results from a Phase 3 study showed a greater than 50 percent reduction in the risk of death or respiratory failure in patients hospitalized with moderate to severe COVID-19.
  • Paxlovid (PF-07321332): Is an oral SARS-CoV2-3CL protease inhibitor.  On November 5, 2021 Pfizer  has announced results which have demonstrated positive results based on the interim analysis of using Paxlovid in the Phase 2/3  EPIC-HR randomized, double-blind study of non-hospitalized adult patients with COVID-19, who are at high risk of progressing to severe illness.
  • Peginterferon Lambda: Clinical trials using Peginterferon Lambda to treat COVID-19 have been completed with varying results. In one trial on non hospitalized COVID-19 patients Peginterferon Lambda increased the proportion of patients with viral clearance by day 7, which could potentially prevent clinical deterioration. In another trial non hospitalized patients with uncomplicated COVID-19 did not have a significant reduction time in viral clearance or resolution of symptoms when compared with placebo.
  • Zyesami (RLF-100: aviptadil) is a formulation of vasoactive intestinal polypeptide (VIP) which binds to alveolar type 2 cells in the lungs inhibiting pro-inflammatory cytokines. Zyesami is currently enrolling patients for Phase 3 trials for hospitalized patients with life-threatening cases of COVID-19 and is part of the  NIH Accelerating COVID-19 Treatment Interventions and Vaccines (ACTIV) public-private partnership.  It is a randomized, blinded, placebo-controlled clinical trial using Zyesami and the antiviral remdesivir (Veklury) both alone and in combination, to treat hospitalized COVID-19 patients who are experiencing Acute Respiratory Distress Syndrome (ARDS).
  • Sarilumab: An interleukin-6 (IL-6) receptor antagonist called sarilumab (marketed under the brand name Kevzara for the treatment of rheumatoid arthritis) has been studied in critically ill COVID-19 patients who were in an intensive care unit (ICU).  Results showed sarilumab improved patient outcomes including survival.  The NIH COVID-19 treatment guidelines have sarilumab as an alternative if tofacitinib is not available, for treatment of hospitalized patients who require oxygen delivery through high-flow device or non invasive ventilation, or invasive mechanical ventilation (IMV) or extracorporeal membrane oxygenation (ECMO).
  • Statins: Statins (HMG CoA reductase inhibitors): The family of cholesterol lowering medications are studied to determine whether they can reduce severity of COVID-19.  Statins are thought to have an anti-inflammatory and immunomodulatory effect. Currently the recommendations for NIH is that if you are already taking a statin prescribed for your health condition, and then get COVID-19 you should continue taking your statin as prescribed.  NIH does not recommend starting statins when you get COVID-19 if you have not been prescribed it for a health condition previously.
  • STC3141: An investigational drug called STC3141 has been approved to commence phase II clinical research in Australia for the treatment of acute respiratory distress syndrome (ARDS) suffered by COVID-19 patients.
  • Umifenovir: An antiviral drug called umifenovir (marketed in Russia under the brand name Arbidol, and also available in China for the treatment of influenza) is being studied in China and other countries as a treatment for COVID-19.

 

Investigational Vaccines

Several pharmaceutical companies and research organizations worldwide are involved in the development of potential vaccines.

  • BBIBP-CorV (Vero cells)  (Also known as Sinopharm BIBP COVID-19 vaccine) Vaccine platform: Inactivated
    On May 26, 2021 JAMA  published a prespecified interim analysis of the Phase 3 trial which showed that the vaccine was 78.1% effective against symptomatic cases and 100% against severe cases.
  • Convidecia (Ad5-nCoV, Pakvac) Vaccine platform: Non Replicating Viral Vector
    CanSino Biologics Inc. has announced that its recombinant novel coronavirus vaccine (Adenovirus Type 5 Vector) candidate (Ad5-nCoV), co-developed with Beijing Institute of Biotechnology (BIB), has been approved to enter into a Phase 1 clinical trial in China. The company announced on February 25, 2021 interim analysis data of the phase III clinical trial of Convidecia shows it has overall efficacy of 65.28% at preventing all symptomatic COVID-19 disease 28 days after single-dose vaccination.
  • CoronaVac Vaccine Platform: Inactivated
    Sinovac Biotech Ltd. interim results of double-blind, randomised, placebo-controlled Phase 3 trials  (NCT04582344) showed high efficacy for preventing symptomatic COVID-19 (83·5% relative to placebo) and COVID-19-related hospitalisation (100%) at least 14 days after the second dose.
  • COVAC1 (LNP-nCoVsaRNA) Vaccine platform: RNA Vaccine
    COVAC1 is a self-amplifying RNA (saRNA) that is lipid nanoparticle (LNP) encapsulated.
    Imperial College London announced in a Preprint with THE LANCET that Phase 1 dose-ranging trial that 87% of the 192 people had a strong antibody response to COVAC1.
  • CVnCoV Vaccine platform: mRNA vaccine
    CureVac AG announced October 12, 2021 that CVnCoV will be withdrawn from regulatory review as CureVac will shift their focus of COVID-19 vaccine development to second-generation mRNA technology.   Phase 2b/3 randomized, observer-blind, placebo-controlled studies had been initiated in December 2020 to assess the dose and efficacy of CVnCoV.
  • GX-19 Vaccine platform: DNA vaccine
    Genexine announced the approval of a clinical phase 1/2a trial of DNA vaccine GX-19 in Korea.
  • INO-4800 Vaccine platform: DNA vaccine
    Inovio Pharmaceuticals, Inc. announced on April 6, 2020 FDA acceptance of the Investigational New Drug (IND) application for its DNA vaccine candidate INO-4800, paving the way for a Phase 1 clinical trial. On June 30, 2020, the company announced positive interim clinical data from the Phase 1 trial, with plans to initiate a Phase 2/3 efficacy trial upon regulatory concurrence. On September 28, 2020, Inovio announced that the planned Phase 2/3 trial of INO-4800 has been put on partial clinical hold at the request of the FDA.  On November 09, 2021 the FDA lifted the partial clinical hold and therefore provided authorization to proceed for Phase 3 trial for its COVID-19 Vaccine Candidate, INO-4800.
  • MRT5500 Vaccine platform: mRNA vaccine
    On September 28, 2021 Sanofi announced it will not pursue the development of MRT5500 and will instead focus on the final development stages of its recombinant COVID-19 vaccine in conjunction with GSK.  Initial data from a Phase 1/2 study showed positive interim results with neutralizing antibody seroconversion in 91% to 100% of study participants, two weeks after the second injection.
  • Novavax COVID-19 Vaccine (NVX-CoV2373) Vaccine platform: Protein Subunit
    On October 10, 2021 a preprint article reported results from a Phase 3, randomized, observer-blinded, placebo-controlled trial. Patients received two doses of NVX-CoV2373 or placebo, given  21 days apart.  Early results, that have yet to be peer reviewed, showed a vaccine efficacy of over 90%.
    On May 25, 2020, Novavax, Inc. announced the commencement of a Phase 1/2 clinical trial of its coronavirus vaccine candidate, NVX-CoV2373, a stable, prefusion protein made using its proprietary nanoparticle technology adjuvant (Matrix-M™) to enhance immune responses and stimulate high levels of neutralizing antibodies, across two sites in Australia. On July 7, 2020, the company announced that it had been selected to participate in Operation Warp Speed, with funding from the federal government to complete late-stage clinical development, including a pivotal Phase 3 clinical trial and the delivery of 100 million doses of NVX-CoV2373 as early as late 2020. On August 4, 2020, Novavax reported Phase 1 data from the Phase 1/2 randomized, observer-blinded, placebo-controlled trial of NVX-CoV2373 with and without Matrix-M™ adjuvant. On August 24, 2020, it was announced that Phase 2 trials had commenced, with approximately 50 percent of participants ≥60 years of age, at up to 40 sites across the U.S. and Australia.
  • SCB-2019 (CpG 1018/Alum) Vaccine platform: Protein Subunit
    On Sep 22, 2021 Clover Pharmaceuticals announced that the randomized, double-blinded, placebo-controlled Phase2/3 SPECTRA Trial had met its primary and secondary endpoints. Efficacy against severe COVID-19 and hospitalization was 100%, and efficacy against moderate-to-severe COVID-19 was 84%.  Efficacy against any severity of the Delta variant of COVID-19 was 79%.  The SCB-2019 antigen is combined with CpG 1018 advanced adjuvant and aluminum hydroxide (alum).
  • Sputnik V (Gam-COVID-Vac) Vaccine platform: Non-Replicating Viral Vector
    On February 2, 2021 interim analysis of results of randomised controlled Phase 3 trial showed Gam-COVID-Vac had a 91.6% efficacy against COVID-19. It is a combined vector vaccine based on recombinant adenovirus type 26 (rAd26)  and recombinant adenovirus type 5 (rAd5)  which are administered intramuscularly separately with a 21-day interval.
  • V590 and V591 Vaccine platform: Replicating Viral Vector
    Merck announced a collaboration with IAVI (International AIDS Vaccine Initiative) to develop an investigational vaccine against SARS-CoV-2, using the recombinant vesicular stomatitis virus (rVSV) technology that is the basis for its Ebola Zaire virus vaccine (Ervebo). On January 25, 2021, the company announced that it was discontinuing the development of its SARS-CoV-2/COVID-19 vaccine candidates (V590 and V591) and confirmed plans to switch focus instead to advancing its therapeutic candidates.
  • Vaxzevria (formerly AZD1222, ChAdOx1 nCoV-19) Vaccine platform: Non-Replicating Viral Vector
    Vaxzevria was developed by Oxford University’s Jenner Institute, with AstraZeneca responsible for development and worldwide manufacturing and distribution.  A randomised, double-blinded, placebo-controlled phase III study  (D8110C00001) of Vaxzevria in the United States, Peru and Chile showed vaccine efficacy was 62.6%  in patients who had had two doses within the recommended dosing interval.  Vaxzevria is authorised for use in the European Union.
  • VXA-CoV2-1 Vaccine platform: Non-Replicating Viral Vector
    On May 3, 2021 Vaxart announced VXA-CoV2-1 would move into Phase 2 studies. It is an oral tablet COVID-19 vaccine which targets both the spike protein (S) and nucleoprotein (N).
     

More information

References

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  • In Vitro Antiviral Activity and Projection of Optimized Dosing Design of Hydroxychloroquine for the Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) https://pubmed.ncbi.nlm.nih.gov/32150618/  Accessed April 30, 2020
  • Lab experiments show anti-parasitic drug, Ivermectin, eliminates SARS-CoV-2 in cells in 48 hours https://www.monash.edu/discovery-institute/news-and-events/news/2020-articles/Lab-experiments-show-anti-parasitic-drug,-Ivermectin,-eliminates-SARS-CoV-2-in-cells-in-48-hours Accessed April 30, 2020
  • Bangkok Post https://www.bangkokpost.com/thailand/general/1860329/woman-74-recovers-from-virus-after-thai-cocktail Accessed April 30, 2020
  • A Trial of Lopinavir–Ritonavir in Adults Hospitalized with Severe Covid-19 https://www.nejm.org/doi/full/10.1056/NEJMoa2001282   Accessed April 30, 2020
  • Efficacy and Safety of Corticosteroids in COVID-19 https://clinicaltrials.gov/ct2/show/NCT04273321 Accessed April 30, 2020
  • Clinical trials for tocilizumab in COVID-19 https://clinicaltrials.gov/ct2/results?cond=COVID&term=tocilizumab&cntry=&state=&city=&dist= Accessed April 30, 2020
  • Clinical trials for umifenovir in COVID-19 https://clinicaltrials.gov/ct2/results?cond=COVID&term=umifenovir&cntry=&state=&city=&dist= Accessed April 30, 2020
  • Safety and Immunogenicity Study of 2019-nCoV Vaccine (mRNA-1273) for Prophylaxis SARS CoV-2 Infection (COVID-19) https://clinicaltrials.gov/ct2/show/NCT04283461  Accessed April 30, 2020
  • CSIRO begins testing Covid-19 vaccineshttps://www.csiro.au/en/News/News-releases/2020/CSIRO-begins-testing-Covid-19-vaccines  Accessed April 30, 2020
  • MIGAL’s Coronavirus Vaccine Project https://www.migal.org.il/en/node/7010   Accessed April 30, 2020
  • Efficacy and tolerability of bevacizumab in patients with severe Covid-19: https://www.nature.com/articles/s41467-021-21085-8

Drugs used to treat COVID-19

The following list of medications are in some way related to, or used in the treatment of this condition.

Drug name Rating Reviews Activity ? Rx/OTC Pregnancy CSA Alcohol
remdesivir 5.2 21 reviews
Rx N X

Generic name: remdesivir systemic

Brand name:  Veklury

Drug class: purine nucleosides, investigational drugs

For consumers: dosage, interactions, side effects

For professionals: AHFS DI Monograph, Prescribing Information

ivermectin Off-label 5.2 5 reviews
Rx C N X

Generic name: ivermectin systemic

Drug class: anthelmintics

For consumers: dosage, interactions, side effects

For professionals: AHFS DI Monograph, Prescribing Information

Off-label: Yes

Pfizer-BioNTech COVID-19 Vaccine 8.6 7 reviews
Rx N

Generic name: sars-cov-2 mrna (tozinameran) vaccine

Drug class: viral vaccines

For consumers: dosage, interactions, side effects

Moderna COVID-19 Vaccine EUA 7.9 11 reviews
Rx N

Generic name: sars-cov-2 (covid-19) mrna-1273 vaccine systemic

Drug class: viral vaccines

For consumers: dosage, interactions, side effects

For professionals: Prescribing Information

Emergency Use Authorization: Yes

Veklury Rate Add review
Rx N X

Generic name: remdesivir systemic

Drug class: purine nucleosides, investigational drugs

For consumers: dosage, interactions, side effects

For professionals: Prescribing Information

bamlanivimab / etesevimab EUA Rate Add review
Rx U

Generic name: bamlanivimab / etesevimab systemic

For consumers:

For professionals: Prescribing Information

Emergency Use Authorization: Yes

Janssen COVID-19 Vaccine EUA 6.5 2 reviews
Rx N

Generic name: sars-cov-2 (covid-19) ad26 vaccine, recombinant systemic

Drug class: viral vaccines

For consumers: dosage, interactions, side effects

Emergency Use Authorization: Yes

REGEN-COV EUA 10 1 review
Rx N

Generic name: casirivimab / imdevimab systemic

Drug class: antiviral combinations

For consumers: dosage, interactions,

For professionals: AHFS DI Monograph, Prescribing Information

Emergency Use Authorization: Yes

sars-cov-2 (covid-19) ad26 vaccine, recombinant EUA 6.5 2 reviews
Rx N

Generic name: sars-cov-2 (covid-19) ad26 vaccine, recombinant systemic

Brand name:  Janssen COVID-19 Vaccine

Drug class: viral vaccines

For consumers: dosage, interactions, side effects

For professionals: Prescribing Information

Emergency Use Authorization: Yes

sars-cov-2 (covid-19) mrna-1273 vaccine EUA 7.9 11 reviews
Rx N

Generic name: sars-cov-2 (covid-19) mrna-1273 vaccine systemic

Brand name:  Moderna COVID-19 Vaccine

Drug class: viral vaccines

For consumers: dosage, interactions, side effects

Emergency Use Authorization: Yes

sars-cov-2 mrna (tozinameran) vaccine 8.6 7 reviews
Rx N

Generic name: sars-cov-2 mrna (tozinameran) vaccine

Brand names:  Pfizer-BioNTech COVID-19 Vaccine, Comirnaty

Drug class: viral vaccines

For consumers: dosage, interactions, side effects

For professionals: Prescribing Information

Actemra EUA Rate Add review
Rx C N

Generic name: tocilizumab systemic

Drug class: interleukin inhibitors

For consumers: dosage, interactions, side effects

For professionals: Prescribing Information

Emergency Use Authorization: Yes

Comirnaty Rate Add review
Rx N

Generic name: sars-cov-2 mrna (tozinameran) vaccine

Drug class: viral vaccines

For consumers: dosage, interactions, side effects

sotrovimab EUA Rate Add review
Rx N

Generic name: sotrovimab systemic

Drug class: miscellaneous antivirals

For consumers: dosage, interactions, side effects

For professionals: Prescribing Information

Emergency Use Authorization: Yes

tocilizumab EUA Rate Add review
Rx C N

Generic name: tocilizumab systemic

Brand name:  Actemra

Drug class: interleukin inhibitors

For consumers: dosage, interactions, side effects

For professionals: AHFS DI Monograph

Emergency Use Authorization: Yes

Topics under COVID-19

Learn more about COVID-19

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Legend

Rating For ratings, users were asked how effective they found the medicine while considering positive/adverse effects and ease of use (1 = not effective, 10 = most effective).
Activity Activity is based on recent site visitor activity relative to other medications in the list.
Rx Prescription only.
OTC Over-the-counter.
Rx/OTC Prescription or Over-the-counter.
Off-label This medication may not be approved by the FDA for the treatment of this condition.
EUA An Emergency Use Authorization (EUA) allows the FDA to authorize unapproved medical products or unapproved uses of approved medical products to be used in a declared public health emergency when there are no adequate, approved, and available alternatives.
Pregnancy Category
A Adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters).
B Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women.
C Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use in pregnant women despite potential risks.
D There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use in pregnant women despite potential risks.
X Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use in pregnant women clearly outweigh potential benefits.
N FDA has not classified the drug.
Controlled Substances Act (CSA) Schedule
M The drug has multiple schedules. The schedule may depend on the exact dosage form or strength of the medication.
U CSA Schedule is unknown.
N Is not subject to the Controlled Substances Act.
1 Has a high potential for abuse. Has no currently accepted medical use in treatment in the United States. There is a lack of accepted safety for use under medical supervision.
2 Has a high potential for abuse. Has a currently accepted medical use in treatment in the United States or a currently accepted medical use with severe restrictions. Abuse may lead to severe psychological or physical dependence.
3 Has a potential for abuse less than those in schedules 1 and 2. Has a currently accepted medical use in treatment in the United States. Abuse may lead to moderate or low physical dependence or high psychological dependence.
4 Has a low potential for abuse relative to those in schedule 3. It has a currently accepted medical use in treatment in the United States. Abuse may lead to limited physical dependence or psychological dependence relative to those in schedule 3.
5 Has a low potential for abuse relative to those in schedule 4. Has a currently accepted medical use in treatment in the United States. Abuse may lead to limited physical dependence or psychological dependence relative to those in schedule 4.
Alcohol
X Interacts with Alcohol.

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Further information

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