Coronavirus infection: principles of ethyotropic chemotherapy

In the development of the infectious process caused by coronaviruses, two stages can be distinguished: early (ethiotropic) and late (pathogenetic). Therapeutic principles depend on these stages. At the first stage, when the virus accumulates, ethiotropic chemotherapeutic drugs suppressing virus reproduction are predominantly used. The article considers 7 major chemotherapeutic approaches aimed at specific targets in the replication of coronaviruses: viral RNA polymerase inhibitors, inhibitors of viral protease Mpro, inhibitors of proteolytic activation of viral protein S, which carries out the virus entry into the target cell, inhibitors of virus uncoating in the intracellular endosomes, exogenous interferon compounds, preparations of natural and recombinant virus neutralizing antibodies, as well as combinations of the above drugs. At the second stage, when the virus multiplication drops down and threatening pathological processes of excessive inflammation, acute respiratory distress syndrome, pulmonary edema, hypoxia and threatening sepsis develop, it is reasonable to realize antipathogenetic approaches, such as extracorporeal blood oxygenation, detoxication, anti-inflammatory and antibacterial therapeutic drugs and measures.