Table 2 demonstrated the pros and cons about some standard anti-viral drugs used to treat SARS-CoV-2

Chloroquine (CQ) and Hydroxychloroquine (HCQ)

(Anti-malarial drugs)

Both are safe anti-inflammatory agents that effectively inhibit the viral entry (Liu et al. 2020)

Both are associated with efficient absorption in different tissues (Liu et al. 2020)

HCQ is more efficient than CQ, based on molecular docking analysis (Achutha et al. 2020)

CQ and HCQ may interfere the functioning of other drugs or at high doses (Pal et al. 2020; Zou et al. 2020)

HCQ is associated with cardiotoxic effects (e.g. drug-induced cardiomyopathy) and gastrointestinal effects (Pal et al. 2020)

Tocilizumab (TCZ) (IL-6 receptor (IL-6R) antagonist)

TCZ act by inhibiting IL-6 binding to receptors and decreasing cytokine storm (Zhanga et al. 2020)

There were no TCZ -linked complications or illness deterioration (Zhanga et al. 2020)

TCZ increases the risk of cardiovascular disease (Zhanga et al. 2020)

TCZ might cause some adverse effects including hepatic damage, neutropenia, thrombocytopenia, or serious secondary infection (Zhangb et al. 2020; Kotak et al. 2020)

Remdesivir (RDV) (A prodrug of an adenosine analogue)

RDV is a broad-spectrum antiviral agent and a potent inhibitor of SARS-CoV-2 replication in nasal and bronchial airway epithelial cells (Doggrell 2020)

RDV decreases the recovery-time in COVID-19 patients and currently is the first approved anti-viral drug against COVID-19 (Beigel et al. 2020)

RDV might cause some side effects such as the elevation in hepatic enzyme levels and diarrhea (Grein et al. 2020)

The poor oral-bioavailability of RDV hindered its prophylactic use (Malin et al. 2020)

Lopinavir/ritonavir (LPVr) (a protease inhibitor)

LPV/r plays an important role in the “early stage i.e. initial 7–10 days” clinical outcome (Yao et al. 2020)

LPV/RTV-treated COVID-19 patients demonstrated a lower mortality rate than HCQ (Karolyi et al. 2020)

LPV might cause some adverse reactions including elevated hepatic enzymes, increased triglycerides, in addition to, diarrhea, nausea, asthenia, and gastrointestinal side effects (Yao et al. 2020)

LPVr could increase the risk of bradycardia (Beyls et al. 2020)

Ribavirin

Ribavirin is a broad-spectrum antiviral drug that is available in oral dosage forms (Wang and Zhu 2020)

Ribavirin demonstrated some adverse reactions including fever, headache, neutropenia, in addition to, hemolytic anemia (Wang and Zhu 2020)

Ribavirin, at high doses, increases the risk of hematologic toxicity, besides, its poor in vitro efficacy and poor outcomes. Therefore, ribavirin was not considered a viable treatment for further investigation by the WHO in COVID-19 patients (McCreary and Pogue 2020)