There Was No New Needle in the COVID Therapeutic Haystack A COVID-19 Therapeutics Analysis

Though there were almost 5,000 FDA-tracked trials, no FDA or EU approved COVID-19 drug was discovered during the pandemic! Fortunately, those discovered before the pandemic proved very effective if they were used early in vaccinated patients. The most powerful drugs were antivirals whose targets were the spike structural protein and two nonstructural proteins, nsp5 (Mpro) and nsp12 (RdRp). Two papers published before the pandemic was declared and one published just after it was declared identified these three targets. Monoclonal antibodies have been used since 1986. New monoclonal antibodies blocked the spike protein from attaching to the cell; however, all were disabled by variants. Drugs that had been used for MERS, Ebola, RSV and other diseases interfered with Mpro’s and RdRp’s viral replication actions. Used since 1900, convalescent plasma, had mixed success. Three rheumatoid arthritis drugs and a glucocorticoid, which is also used to treat arthritis, are the only approved drugs to treat hyperinflammation. No new approaches for blood clots or oxygenation were developed. Even with the wartime like focus, and intensity, still no respiratory illness has been cured. Using a personal data base of 3,050 therapeutics papers, the FDA Clinical Tracker, and Google Scholar, this review will discuss approved, promising and ineffectual therapeutics.