However, there are some differences between these two agents regarding the mode of action, receptor affinity and dose of administration

However, there are some differences between these two agents regarding the mode of action, receptor affinity and dose of administration. by inhibiting the SARS-CoV-2 entry and interacting with glycosylation of ACE2 receptor and it’s binding with RBD [10,30]. HCQ may help s to destroy the computer AG-126 virus into the cytoplasm, through the action of lysosomes and blocks its presentation through the major histocompatibility complex (MHC) to T-cells [31]. Both drugs were used widely in the first days of the pandemic, but the results of the trials were inconclusive [11,32]. (3) studies [33]. It is approved by the FDA for the treatment of adult hospitalized COVID-19 patients and in pediatric populace aged? ?12 years. It has been studied in many clinical trials with promising results in some patients [33], AG-126 [34], [35], [36]. Other antiviral brokers have been proposed and used in hospitalized COVID-19 patients such as, lopinavir and/or ritonavir in combination with ribavirin. (4) em Lopinavir-Ritonavir /em In a randomized controlled open-label trial involving hospitalized adult COVID-19 patients, Cao et?al. evaluated the effectiveness of lopinavir-ritonavir (400?mg and 100?mg) in addition to standard of care (SC), twice daily for 14 days versus SC alone. A total of 199 patients were randomized in which 99 were assigned to lopinavir-ritonavir group, while 100 to the SC group. No benefit was observed with lopinavir-ritonavir treatment beyond SC [37]. (5) em Triple therapy /em An open-label randomized, phase-2 trial using triple combination of interferon beta-1b, lopinavir-ritonavir and ribavirin conducted by Hung et?al. in hospitalized patients with moderate to moderate COVID-19 disease. At that time, 86 patients were assigned to receive combination triple therapy, while 41 were assigned to receive lopinavir-ritonavir alone. Triple antiviral therapy was superior to lopinavir-ritonavir in alleviating symptoms AG-126 and shortening the duration of viral shedding and hospital stay in patients with moderate to moderate COVID-19 [38]. Other antiviral agents have been AG-126 investigated in several clinical trials for the treatment of COVID-19 and some of them have received emergency use authorization from the FDA for the treatment of nonhospitalized patients. (6) em Ritonavir-boosted nirmatrevil /em Ritonavir-boosted nirmatrevil, is an orally used drug for high risk non-hospitalized adults with COVID-19. Treatment of symptomatic COVID-19 ritonavir-boosted nirmatrevil resulted in high risk progression to severe COVID-19 that was 89% lower than placebo [39]. (7) em Molnupiravir /em Molnupiravir, is an orally used drug for several RNA viruses, including SARS-CoV-2. It is used in high risk nonhospitalized patients. Indeed, early treatment with molnupiravir reduced the risk of hospitalization or death in unvaccinated COVID-19 adult patients [40]. (B) Targeting cell membrane receptors, sensors and signaling (1) em Colchicine /em It is a tricyclic alkaloid, a potent anti-inflammatory AG-126 agent used in rheumatology for TSPAN9 many years to treat gout, pseudogout and Familial Mediterranean Fever (FMF) as well as some heart disorders [41]. Colchicine is usually a potent inhibitor of tubulin polymerization. Microtubules are the main tools of cytoskeleton involved in many cellular processes [42]. Furthermore, colchicine inhibits neutrophil and monocyte chemotaxis and the expression of adhesion molecules in the setting of inflammation. It inhibits also Nod-Like Receptor (NLR) protein-3 inflammasome (NLRP3) suppressing Caspase-1 activation, resulting in inhibition of IL-1 [41,42]. Colchicine used in patients with gout and FMF, who contracted SARS-CoV-2 contamination, may mitigate the COVID-19 computer virus and its outcome [43,44]. Given the above mechanism of action, colchicine was studied in non-hospitalized and hospitalized patients with COVID-19, and the results showed some beneficial effects on disease outcome [45]. In a large placebo-controlled trial (COLCORONA), Tardif et?al. evaluated the use of colchicine (0,5?mg twice daily) in patients with positive test for SARS-CoV-2 contamination at the time of inclusion, regardless of symptoms, with at least one risk factor for COVID-19. The study included 4488 patients of which.