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Role of ACE2 receptor and the landscape of treatment options from convalescent plasma therapy to the drug repurposing in COVID-19

  • Kumar, Pravindra1
  • Sah, Ashok Kumar2
  • Tripathi, Greesham3
  • Kashyap, Anjali4
  • Tripathi, Avantika3
  • Rao, Rashmi1
  • Mishra, Prabhu C.3
  • Mallick, Koustav5
  • Husain, Amjad6, 6
  • Kashyap, Manoj Kumar3
  • 1 The Glocal University,
  • 2 Amity Medical School, Amity University Haryana,
  • 3 Amity University Haryana,
  • 4 Thapar Institute of Engineering & Technology,
  • 5 Institute of Liver and Biliary Sciences,
  • 6 Indian Institute of Science Education and Research,
Published Article
Molecular and Cellular Biochemistry
Publication Date
Oct 07, 2020
DOI: 10.1007/s11010-020-03924-2
PMID: 33029696
PMCID: PMC7539757
PubMed Central


Since the first case reports in Wuhan, China, the SARS-CoV-2 has caused a pandemic and took lives of > 8,35,000 people globally. This single-stranded RNA virus uses Angiotensin-converting enzyme 2 (ACE2) as a receptor for entry into the host cell. Overexpression of ACE2 is mainly observed in hypertensive, diabetic and heart patients that make them prone to SARS-CoV-2 infection. Mitigations strategies were opted globally by the governments to minimize transmission of SARS-CoV-2 via the implementation of social distancing norms, wearing the facemasks, and spreading awareness using digital platforms. The lack of an approved drug treatment regimen, and non-availability of a vaccine, collectively posed a challenge for mankind to fight against the SARS-CoV-2 pandemic. In this scenario, repurposing of existing drugs and old treatment options like convalescent plasma therapy can be one of the potential alternatives to treat the disease. The drug repurposing provides a selection of drugs based on the scientific rationale and with a shorter cycle of clinical trials, while plasma isolated from COVID-19 recovered patients can be a good source of neutralizing antibody to provide passive immunity. In this review, we provide in-depth analysis on these two approaches currently opted all around the world to treat COVID-19 patients. For this, we used “Boolean Operators” such as AND, OR & NOT to search relevant research articles/reviews from the PUBMED for the repurposed drugs and the convalescent plasma in the COVID-19 treatment. The repurposed drugs like Chloroquine and Hydroxychloroquine, Tenofovir, Remdesivir, Ribavirin, Darunavir, Oseltamivir, Arbidol (Umifenovir), Favipiravir, Anakinra, and Baricitinib are already being used in clinical trials to treat the COVID-19 patients. These drugs have been approved for a different indication and belong to a diverse category such as anti-malarial/anti-parasitic, anti-retroviral/anti-viral, anti-cancer, or against rheumatoid arthritis. Although, the vaccine would be an ideal option for providing active immunity against the SARS-CoV-2, but considering the current situation, drug repurposing and convalescent plasma therapy and repurposed drugs are the most viable option against SARS-CoV-2. Electronic supplementary material The online version of this article (10.1007/s11010-020-03924-2) contains supplementary material, which is available to authorized users.

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