Are the newly authorized antiviral drug treatment for non-severe COVID-19 may change the course of the pandemic?

Abstract

Since the emergence of the coronavirus disease-2019 (COVID-19) pandemic has killed over 6.83 million and infected 670 million people worldwide. The disease is evolving, and numerous COVID-19 prevention and treatment have been approved or suggested. The only antiviral currently approved by the Food and Drug Administration (FDA) for the treatment of COVID-19 is remdesivir (brand name Veklury). Molnupiravir (brand name Lagevrio) and ritonavir-booster nirmatrelvir (brand name Paxlovid) have been granted Emergency Use Authorizations (EUAs) for the treatment of COVID-19. Despite these antivirals having demonstrated efficacy for the treatment of mild-to-moderate COVID-19 in authorized patients; however, there is a restriction to who can take these antivirals due to the inaccessibility and drug-to-drug interactions that can be lethal to many immunocompromised and severe liver disease patients. With thousands of new COVID-19 cases reported daily, there needs to be more effective strategies to increase the accessibility of antivirals to stir the course of the pandemic and move out of it. This paper will review the current knowledge on antivirals for the treatment of SARS-CoV-2 and its mechanisms and highlight key research areas in the field that remain to be understood regarding antivirals, focusing on 1) why antivirals are inaccessible to many patients,  2) explore possible new treatments that could mitigate COVID-19 related inequalities and drug accessibility. By understanding the accessibility and mechanisms of the antivirals for COVID-19, researchers and health authorities will be able to promote effective and novel treatments and bring hope for more antivirals to change the course of the pandemic.