COVID-19 may lead to severe respiratory distress syndrome and high risk of death in some patients. So far (January 2021), only the antiviral remdesivir has been approved, although no significant benefits in terms of mortality and clinical improvement were recently reported. In a setting where effective and safe treatments for COVID-19 are urgently needed, drug repurposing may take advantage of the fact that the safety profile of an agent is already well known and allows rapid investigation of the efficacy of potential treatments, at lower costs and with reduced risk of failure. Furthermore, novel pharmaceutical formulations of older agents (e.g., aerosolized administration of chloroquine/hydroxychloroquine, remdesivir, heparin, pirfenidone) have been tested in order to increase pulmonary delivery and/or antiviral effects of potentially active drugs, thus overcoming pharmacokinetic issues. In our review, we will highlight the importance of the drug repurposing strategy in the context of COVID-19, including regulatory and ethical aspects, with a specific focus on novel pharmaceutical formulations and routes of administration.

中文翻译：

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COVID-19时代的药物再利用：个案研究的启示，揭示了药物的特殊性

COVID-19可能导致严重的呼吸窘迫综合征和某些患者的高死亡风险。到目前为止（2021年1月），仅抗病毒药物瑞姆昔韦被批准，尽管最近在死亡率和临床改善方面尚无明显报道。在迫切需要有效且安全的COVID-19治疗的情况下，重新利用药物可能会利用以下事实：药剂的安全性已经众所周知，并可以以较低的成本和成本快速调查潜在治疗的功效。降低了失败的风险。此外，新型的老年药物制剂（例如，氯喹/羟氯喹，雷姆昔韦，肝素，为了增加肺部传递和/或潜在活性药物的抗病毒作用，已对吡非尼酮进行了测试，从而克服了药代动力学问题。在我们的综述中，我们将在COVID-19的背景下强调药物重用策略的重要性，包括监管和道德方面，特别关注新型药物制剂和给药途径。