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Nucleoside analogs for management of respiratory virus infections: mechanism of action and clinical efficacy

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CURRENT OPINION IN VIROLOGY
卷 57, 期 -, 页码 -

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ELSEVIER SCI LTD
DOI: 10.1016/j.coviro.2022.101279

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  1. (NIH) National Institutes of Health [P41-GM103311]

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The COVID-19 pandemic has accelerated the development of nucleoside analogs for treating respiratory virus infections. Remdesivir is the first authorized compound, and three other nucleoside analogs are in the pipeline. This article summarizes the current knowledge on their clinical efficacy and mentions trials for influenza and respiratory syncytial virus. Furthermore, it outlines how nucleoside analogs interact with respiratory virus polymerases to cause lethal virus mutagenesis or disturbance of viral RNA synthesis.
The COVID-19 pandemic has accelerated the development of nucleoside analogs to treat respiratory virus infections, with remdesivir being the first compound to receive worldwide authorization and three other nucleoside analogs (i.e. favipiravir, molnupiravir, and bemnifosbuvir) in the pipeline. Here, we summarize the current knowledge concerning their clinical efficacy in suppressing the virus and reducing the need for hospitalization or respiratory support. We also mention trials of favipiravir and lumicitabine, for influenza and respiratory syncytial virus, respectively. Besides, we outline how nucleoside analogs interact with the polymerases of respiratory viruses, to cause lethal virus mutagenesis or disturbance of viral RNA synthesis. In this way, we aim to convey the key findings on this rapidly evolving class of respiratory virus medication.

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