Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Antivirals and Biologics for Broader Coverage Against Human Coronaviruses

Version 1 : Received: 10 December 2023 / Approved: 11 December 2023 / Online: 12 December 2023 (07:45:11 CET)

A peer-reviewed article of this Preprint also exists.

Outteridge, M.; Nunn, C.M.; Devine, K.; Patel, B.; McLean, G.R. Antivirals for Broader Coverage against Human Coronaviruses. Viruses 2024, 16, 156. Outteridge, M.; Nunn, C.M.; Devine, K.; Patel, B.; McLean, G.R. Antivirals for Broader Coverage against Human Coronaviruses. Viruses 2024, 16, 156.

Abstract

Coronaviruses (CoVs) are enveloped positive-sense single-stranded RNA viruses with a genome 27-31kbases in length. Critical genes include the spike (S), envelope (E), membrane (M), nucleocapsid (N) and 9 accessory open reading frames encoding for non-structural proteins (NSPs) that have multiple roles in the replication cycle and immune evasion (1). There are 7 known human CoVs that most likely appeared after zoonotic transfer, the most recent being SARS-CoV-2 responsible for the Covid-19 pandemic. Antivirals that have been approved by the FDA for use against Covid-19 such as Paxlovid can potentially target and successfully inhibit the main protease (MPro) activity of multiple human CoVs, however alternative proteomes encoded by CoV genomes have a closer genetic similarity to each other, suggesting that antivirals could be developed now that target future CoVs. New zoonotic introductions of CoVs to humans are inevitable and unpredictable. Therefore, new antivirals are required to control not only the next human CoV outbreak, but also the 4 common human CoVs (229E, OC43, NL63, HKU1) that circulate frequently and to contain sporadic outbreaks of the severe human CoVs (SARS-CoV, MERS and SARS-CoV-2). The current study found that emerging antiviral drugs, such as Paxlovid, have only been proven to target SARS-CoV-2. Other drugs which have the potential to target other human CoVs, are still within clinical trial and are not yet available for public use. Monoclonal antibody (mAb) treatment and vaccines for SARS-CoV-2 can reduce mortality and hospitalisation rates, however they target the Spike protein whose sequence mutates frequently and drifts. Spike also is not applicable for targeting other HCoVs as these are not well conserved sequences among human CoVs. Thus, there is a need for readily available treatments globally that target all 7 human CoVs and improve the preparedness for inevitable future outbreaks. Here we discuss antiviral research contributing to the control of common and severe CoV replication and transmission, including the current SARS-CoV-2 outbreak. The aim was to identify common features of CoVs for antivirals, biologics and vaccines that could reduce the scientific, political, economic and public health strain caused by CoV outbreaks now and in the future.

Keywords

coronavirus; antiviral; biologic

Subject

Biology and Life Sciences, Virology

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