An overview on the use of antivirals for the treatment of patients with COVID19 disease.

Introduction: There is an urgent need for safe and efficacious antiviral drugs to improve outcomes for COVID-19 patients. Understanding SARS-CoV-2 virology can elucidate potential drug targets for the inhibition of viral replication. Areas covered: This review offers insights into novel and repurposed drugs that may have activity against SARS-CoV-2. We searched the PubMed, Medline, Google Scholar, Web of Science and ClinicalTrials.gov for COVID-19 related therapy until 28 October 2020. using search words 'SARS-CoV-2', 'COVID-19', 'antiviral', and/or 'treatment'. Expert opinion: Remdesivir decreased symptom duration modestly but had no significant impact on survival. Antivirals alone may be insufficient for a specific subset of patients with severe disease because of cytokine release syndrome (CRS). Treatment may require a combination of antivirals and immunomodulators to inhibit viral replication and CRS, respectively. A safe and efficacious SARS-CoV-2 specific vaccine is critical for prevention and mortality reduction. Moreover, we cannot overstate the importance of randomized controlled trials (RCTs) in testing of novel treatments. The pervasive stumbling block, however, is the low representation of minority groups. The benefit of remdesivir may not be generalizable to these populations because of significant underrepresentation in trials. Future endeavors should encompass the recruitment of patient populations that are reflective of the demographics significantly impacted by COVID-19.