Trends in COVID-19 Treatment and Vaccine Development

With the ongoing pandemic of COVID-19, we have been facing an unprecedented situation. The world of research has been shaken by current events just as much as other parts of our lives. The sheer amount of scientific output is staggering – from February to July 2020, approximately 4 % of published scientific papers were related to COVID-19¹ – and is still growing, now counting in tens of thousands of articles. Preprint servers have also experienced a boom like no other². This makes analyzing and processing the data extremely difficult and calls for the use of artificial intelligence-based approaches. 

One of the AI-based approaches to process scientific data related to COVID-19 treatment is the „Up-to-date mapping of COVID-19 treatment and vaccine development“ project. The resulting database currently contains more than 800 substances – what are they and how does the focus change over time?

Overall, the research has gone in two different directions. The first is an emphasis on the already established drugs used to treat other diseases, which are being tested on humans with a focus on their efficacy and safety. Currently, there are 363 drugs used for other diseases in the database that have shown potential regarding COVID-19 treatment. The first data came from China, where they formulated treatment guidelines recommending the use of the HIV fixed-dose combination lopinavir/ ritonavir, anti-influenza drug Arbidol, antiviral drug ribavirin, antimalarial drugs chloroquine, and immunosuppressive drug tocilizumab. Chloroquine, together with another antimalarial drug, hydroxychloroquine, were the first drugs to receive emergency use authorization by the FDA in March 2020. Their popularity was largely affected by the USA's president promoting their usage. However, both chloroquine and hydroxychloroquine had their emergency use authorization revoked in June due to safety and efficacy concerns based on new scientific data³. Nevertheless, these substances are one of the best-studied treatment options for COVID-19.

On the other hand, the list of candidate substances is being expanded by numerous screening studies that look for novel substances effective against the virus SARS-CoV-2 or the disease itself. Probably the most successful substance not previously indicated for other diseases is the antiviral medication remdesivir. It was previously tested for several viral infections but found ineffective in those cases. As a treatment for COVID-19, remdesivir has been authorized in the USA, the EU, and several other countries⁴. Furthermore, there is a lot of candidate substances in development – 349, including various candidate vaccines. Interestingly, there are some natural products – currently 96 – that have shown some effect against the virus or the disease. However, the majority of these substances do not undergo follow-up research. Apart from some traditional Chinese medicine, which has been used also for COVID-19, their potential against COVID-19 are not truly researched.

A staggering 82 % of substances in our database are referenced by only one study each. Therefore, there are still many candidate substances available for further testing – while many of them would likely be shown ineffective against COVID-19, there might be some hidden gems in there. Who knows, one of them could be the cure we are all waiting for! 

References

1. Odone et al., “The first 10,000 COVID-19 papers in perspective: Are we publishing what we should be publishing?,” Eur. J. Public Health, Aug. 2020.
2. https://www.nature.com/articles/d41586-020-01394-6
3. https://www.fda.gov/media/138945/download
4. https://www.ema.europa.eu/en/news/first-covid-19-treatment-recommended-eu-authorisation; https://www.fda.gov/news-events/press-announcements/covid-19-update-fda-broadens-emergency-use-authorization-veklury-remdesivir-include-all-hospitalized