Newer Oral Antiviral for the Treatment of COVID-19 Infection

Abstract

The global Coronavirus disease 2019 (COVID-19) pandemic, caused by Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, has indeed seen the emergence of multiple variants. There are several direct-acting antiviral drugs that have been approved or are in process of advancing through clinical development for the treatment of SARS-CoV-2 infection. The oral antiviral medications offer several advantages over intravenous(IV) antivirals, including enhanced safety and the ability to administer during the early stages of the disease to potentially prevent hospitalization. The Food and Drug Administration (FDA) has granted an emergency use authorization (EUA) for an oral antiviral medications Molnupiravir, Nirmatrelvir-Ritonavir and VV116 specially intended for the treatment of mild to moderate COVID-19 in patients at risk of progressing to severe disease. These three mentioned drugs serve different purposes - Molnupiravir is a nucleoside analogue, Nirmatrelvir is a SARS-CoV-2 main protease inhibitor and Ritonavir is used as a protease inhibitor for human immunodeficiency virus type 1. VV116 is a promising oral nucleoside drug candidate with the potential to effectively inhibit SARS-CoV-2 replication, reduce viral RNA levels and limit the presence of infectious virus. The findings are consistent with the observation that the target proteins of the mentioned antiviral drugs, specifically the viral RNA-dependent RNA polymerase and the viral main protease are highly conserved. This suggests that these antivirals may be effective against a broad range of viral strains due to the conservation of their target proteins.