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Immune or “convalescent” plasma refers to plasma collected from infected individuals, post resolution of infection. These infected individuals develop antibodies against the infection. Passive antibody administration through transfusion of convalescent plasma may offer a short-term strategy to confer immediate immunity to severe COVID-19 patients. Antibodies generated against SARS-CoV spike protein may offer certain degree of protection against SARS-CoV-2. The sera from convalescent SARS patients may cross-neutralize the SARS-2-Spike protein driven virus entry into the host cell.

There are around 23 clinical trials (highest phase-3) studying the safety/efficacy of convalescent plasma therapy to treat COVID-19 patients. Interaction of spike protein and the ACE-2 cellular receptor is required for membrane fusion and entry into the target cell. A more refined strategy could be the development of monoclonal antibodies targeting spike protein of SARS-CoV-2. Hence, development and use of monoclonal neutralizing antibodies may be a viable approach for the treatment of COVID-19 disease.

Excelra’s open-access COVID-19 Drug Repurposing Database is a synoptic compilation of ‘Approved’ small molecules and biologics, which can rapidly enter either Phase 2 or 3, or may even be used directly in clinical settings against COVID-19. The database additionally includes information on promising drug candidates that are in various clinical, pre-clinical and experimental stages of drug discovery and development.

Supported with referenced literature, we provide mechanistic insights into SARS-CoV-2 biology and disease pathogenesis. We hope that these drug repositioning approaches can help the global biotech and pharma community develop treatments to combat COVID-19.