While it's still too soon to know which of those many projects might be the one to turn the tide in the fight against the novel coronavirus (officially known as SARS-CoV-2), several are emerging as frontrunners.
We've highlighted those promising projects below, with the latest information on their timeline, as well as listed every other coronavirus treatment and vaccine currently in the works, providing links to pages where you can read more about each.
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These researchers all deserve recognition for their work as, ultimately, it might end up being a combination of multiple projects that ends the COVID-19 outbreak — killing it not with a single mighty blow, but a thousand cuts.
We've also highlighted a few groups working to improve coronavirus testing, as their efforts to rapidly — and affordably — identify infected people could prove instrumental to ending the coronavirus pandemic, too.
We plan to update this list throughout the COVID-19 outbreak, so if you know about a coronavirus treatment, vaccine, or notable testing innovation that we haven't included, let us know at [email protected].
The Flu Drug (Favipiravir)
Details: Developed by Fujifilm Toyama Chemical in 2014 as a treatment for influenza, favipiravir (brand name Avigan) has gotten new life as a promising coronavirus treatment.
On March 18, Japanese media reported that the drug had proven both safe and effective in two trials treating a total of 320 coronavirus patients.
One of the trials involved 80 coronavirus patients, and doctors reported that those who received the drug tested negative for COVID-19 after a median of four days — less than half the 11 days reported for untreated patients.
Timeline: Because favipiravir was developed as a flu treatment, it will need the approval of the Japanese government before it can be widely used on COVID-19 patients. That approval could arrive as soon as May, a health official told Japanese newspaper The Mainichi.
Update, 4/8/20: On April 7, the FDA authorized three Massachusetts hospitals to launch small trials (50 to 60 people total) of favipiravir, marking the first such trials in the U.S.
The Arthritis Drug (Sarilumab)
Details: French pharmaceutical company Sanofi and New York biotech company Regeneron co-developed sarilumab (brand name Kevzara), which U.S. regulators approved as a treatment for rheumatoid arthritis in 2017.
Sarilumab blocks interleukin 6 (I-6), an immune system protein believed to play a role in the appearance of many rheumatoid arthritis symptoms.
Research indicates that many people who died of COVID-19 did so because their immune system overreacted to the virus, damaging their healthy lung tissue and causing organ failure — and blocking I-6 could potentially prevent this overreaction.
Timeline: On March 16, Sanofi and Regeneron announced that they were beginning a two-phase trial of sarilumab on patients with severe cases of COVID-19 in New York. They plan to eventually include 400 patients at 16 U.S. sites in the trials, which have no announced end date.
Update, 6/29/20: Sanofi and Regeneron have stopped offering sarilumab to trial patients with "severe" cases of COVID-19 as it produced negative trends in that group during Phase 2 testing. They are now offering the drug only on "critical" patients as the trend for that group was positive.
The Malaria Drug (Chloroquine)
Details: Chloroquine has been in use as a malaria drug since 1944, and like sarilumab, it's also occasionally prescribed to treat rheumatoid arthritis.
In vitro studies have shown the drug to be highly effective at both preventing and treating SARS infections, a closely related coronavirus disease that emerged in China in 2003. More recently, researchers in China, France, and South Korea have reported promising results from tests of chloroquine as a COVID-19 treatment.
On March 19, President Donald Trump announced during a press briefing that the U.S. planned to conduct its own large clinical trial of chloroquine and its alternative formulation, hydroxychloroquine, as a coronavirus treatment.
Timeline: Neither Trump nor FDA Commissioner Stephen Hahn provided a specific timeline for the chloroquine trial, but given the fact that it has already been approved for other uses, it could likely be deployed as a coronavirus treatment more quickly than a brand-new drug.
Update, 3/25/20: The World Health Organization has launched the SOLIDARITY trial, a large clinical trial through which it will test several promising treatments, including both chloroquine and hydroxychloroquine, on potentially thousands of COVID-19 patients in dozens of countries.
Update, 3/30/20: The FDA has granted emergency use authorization for doctors to distribute and prescribe chloroquine and hydroxychloroquine as coronavirus treatments under certain conditions.
Update, 5/26/20: On May 22, the Lancet published a study that found that coronavirus patients not only didn't benefit from hydroxychloroquine or chloroquine, but the drugs appeared to increase the risk of death. In response, the WHO announced on May 25 that it was halting its studies of hydroxychloroquine as a potential coronavirus treatment.
Update, 6/18/20: On June 15, the FDA revoked its EUA for chloroquine and hydroxychloroquine. Two days later, the WHO officially dropped hydroxychloroquine from its large clinical trial.
The Ebola Drug (Remdesivir)
Details: Like favipiravir and sarilumab, remdesivir wasn't intended as coronavirus treatment — Gilead Sciences initially developed the drug as a potential weapon against Ebola.
Remdesivir didn't prove effective against Ebola, but in animal testing, it did show promise as a treatment for other viruses, including the coronaviruses MERS and SARS.
In February, health officials began testing remdesivir on COVID-19 patients, and during a February 24 COVID-19 press conference, the World Health Organization's Bruce Aylward singled out the drug for praise.
"There's only one drug right now that we think may have real efficacy," he said, "and that's remdesivir."
Timeline: Researchers are currently exploring remdesivir's potential use as a coronavirus treatment in five separate clinical trials, with the first results expected to arrive in April.
Update, 3/25/20: Remdesivir will be one of the drugs tested on potentially thousands of COVID-19 patients in dozens of countries through the WHO's SOLIDARITY trial.
Update, 4/13/20: On April 10, Gilead Sciences released the results of a remdesivir trial involving 53 patients with severe cases of COVID-19. More than two-thirds of the patients improved after receiving the drug, but researchers say they're unable to draw any hard conclusions from the trial due to its lack of a control arm.
Update, 4/17/20: Researchers at the University of Chicago Medicine reported promising results in a remdesivir trial of 125 people with COVID-19, noting that the vast majority were discharged from the hospital within a week of beginning treatment.
Update, 4/30/20: On April 29, the NIH reported that patients given remdesivir in a randomized, controlled trial involving 1,063 people had a 31% faster time to recovery than those given a placebo, based on preliminary data analysis.
Update, 5/4/20: On May 1, the FDA issued Gilead Sciences an emergency use authorization for remdesivir as a potential COVID-19 treatment.
Update, 6/29/20: Gilead Sciences announced that it would charge the U.S. government $390 per vial of remdesivir and private insurance companies $520 per vial. That price that equates to an expected per patient treatment cost of $2,340 and $3,120, respectively.
The HIV Drugs (Lopinavir and Ritonavir) (added 3/25/20)
Details: As early as January, biopharmaceutical company AbbVie was supplying China with its HIV drug combination lopinavir and ritonavir (brand name Kaletra) following unconfirmed reports that it effectively treated COVID-19.
In March, the company began collaborating with several organizations, including the FDA and the CDC, on formal clinical trials.
A small Chinese study of the drug combination published on March 18 reported disappointing results, but the WHO has decided to test the efficacy of both the lopinavir/ ritonavir combination and the combination plus interferon-beta on patients in its SOLIDARITY trial.
Timeline: The WHO launched the SOLIDARITY trial on March 18 and is already enrolling patients. No word yet on when results will be available, but the WHO's Director-General Tedros Adhanom Ghebreyesus has said its goal is to "generate robust, high-quality evidence as fast as possible."
Update, 6/29/20: A University of Oxford-led trial found that 1,596 hospitalized COVID-19 patients given lopinavir-ritonavir did no better than the 3,376 patients in their control group.
Update, 7/6/20: The WHO announced on July 4 that it was discontinuing the lopinavir/ritonavir arm of the SOLIDARITY trial.
The Antibody Drug (LY-CoV555) (added 6/4/20)
Details: Several studies have shown that injections of antibody-rich blood plasma from coronavirus survivors can help current patients overcome the disease, a treatment known as "convalescent plasma therapy."
Now Canadian biotech firm AbCellera and U.S.-based pharmaceutical company Eli Lilly have used a blood sample from a single coronavirus survivor to develop LY-CoV555, a drug that contains a coronavirus antibody that, in animal models, effectively prevented the virus from infecting cells.
If LY-CoV555 does well in human trials, Eli Lilly expects it could manufacture several hundred thousand doses before the end of 2020.
Timeline: Eli Lilly kicked off its first human trial of LY-CoV555 on June 1, giving it to 32 hospitalized COVID-19 patients in the U.S. The results of that trial could arrive by the end of June, and the pharma company hopes to launch large efficacy trials soon after.
The Steroid (Dexamethasone) (added 6/18/20)
Details: A large clinical trial of COVID-19 patients in the United Kingdom has reportedly discovered the first life-saving coronavirus drug — and it's a cheap, readily available steroid called dexamethasone.
The RECOVERY trial researchers say the survival rate for ventilated patients treated with dexamethasone increases from 60% to 72% — meaning for every eight patients treated, the drug will save one life. For less severe cases that require only supplemental oxygen, the drug increases survival rates from 75% to 80%.
The steroid had no measurable benefit for patients with milder cases of COVID-19. However, it's incredible cheap: a 10-day course costs less than $7.
Timeline: The RECOVERY researchers advised doctors to immediately begin using dexamethasone to treat patients with more severe cases of COVID-19. They've yet to published the details of their study, but claim they are working to share them as soon as possible.
Moderna's RNA Vaccine (mRNA-1273)
Details: Massachusetts-based biotech company Moderna Inc. is co-developing mRNA-1273 with the National Institutes of Health (NIH). It is the first coronavirus vaccine to reach the clinical trial stage in the United States.
Rather than containing a weakened form of the novel coronavirus — an approach taken by many vaccine manufacturers — Moderna's vaccine contains synthetic messenger RNA (mRNA).
This mRNA instructs the body's cells to produce the exact antibodies we want against the novel coronavirus, meaning it could protect a person against the virus without exposing them to any form of it.
Timeline: Human tests began at Seattle's Kaiser Permanente Washington Health Research Institute on March 16 with 45 participants. If mRNA-1273 doesn't produce any troubling side effects, a larger follow-up trial will test the vaccine's efficacy at stimulating immunity.
Update, 5/12/20: On May 6, the FDA cleared Moderna to advance its vaccine to a Phase 2 trial involving 600 participants. On May 12, it then granted the company's vaccine a "fast-track" designation. A Phase 3 trial could follow as soon as early this summer, the company said.
Update, 5/18/20: On May 18, Moderna reported that, based on the first eight participants in its Phase 1 trial, mRNA-1273 appears to be both safe and able to stimulate an immune response against the novel coronavirus.
Update, 6/29/20: On June 11, Moderna announced that it had fully enrolled participants in its Phase 2 trial. It also announced that it had finalized the design for a 30,000-subject Phase 3 vaccine trial, which it expects to launch in July.
CanSino's Viral-Vector Vaccine (Ad5-nCoV)
Details: CanSino Biologics is co-developing its viral-vector vaccine (Ad5-nCoV) with the PLA's Academy of Military Medical Sciences. The company has revealed little about the vaccine, other than the fact that it produced immunity when tested in animals.
On March 17, the company announced that it had received approval from Chinese regulators to begin clinical trials of Ad5-nCoV — and as the first coronavirus vaccine in China to reach the human testing stage, it's well worth keeping an eye on.
Timeline: CanSino plans to begin testing its vaccine on 108 healthy adults in April in Wuhan, China — the epicenter of the coronavirus outbreak. The trial will reportedly continue through the end of 2020.
Update, 4/17/20: On April 10, CanSino launched its Phase 2 trial of Ad5-nCoV, which will involve 500 healthy adults. Within five days of the announcement, more than half of participants had already received their injections, according to state media.
Update, 5/27/20: On May 22, CanSino published a promising update on its Phase 1 trial in The Lancet, reporting that the vaccine prompted the creation of coronavirus antibodies in study participants.
Update, 6/29/20: On June 29, CanSino announced that its Ad5-nCoV vaccine had been approved for use by the Chinese military.
Inovio's DNA Vaccine (INO-4800)
Details: Inovio Pharmaceuticals is co-developing INO-4800 with Chinese manufacturer Beijing Advaccine Biotechnology, supported by funding from the Bill and Melinda Gates Foundation.
INO-4800 contains synthetic DNA that prompts the body to produce protective antibodies against the novel coronavirus, and the fact that it doesn't include any of the virus itself could expedite its development.
Timeline: INO-4800 is currently in pre-clinical studies, with human trials expected to begin in April. Inovio says it expects to produce one million doses of the vaccine for future clinical trials before the end of 2020.
Update, 4/8/20: On April 6, Inovio began testing its vaccine on humans in a trial that will involve up to 40 people in Philadelphia, Pennsylvania, and Kansas City, Missouri. Each participant will receive two doses of the vaccine, delivered four weeks apart, to test its safety. If all goes well, a second trial to test the vaccine's efficacy will follow.
Update, 7/6/20: On June 30, Inovio announced the preliminary data from the Phase 1 trial, reporting that INO-4800 appears both safe and well-tolerated by participants. It plans to launched a Phase 2 and 3 efficacy trial this summer if given regulatory approval.
The Tuberculosis Vaccine (added 4/1/20)
Details: Each year, more than a million children in nations still battling tuberculosis receive the bacillus Calmette-Guérin (BCG) vaccine.
Some studies have suggested that the vaccine broadly boosts a recipient's immune system, leading to speculation that it might be able to help a person battle a coronavirus infection — or avoid catching the virus altogether.
So, while the aforementioned groups work to develop a brand-new coronavirus vaccine, several nations are launching trials to see if the century-old tuberculosis vaccine can protect people against SARS-CoV-2.
Timeline: Trials of the BCG vaccine are poised to begin in the Netherlands, the United States, Australia, and elsewhere. Results may be available within a few months.
Update, 04/24/20: A study published on the preprint server medXriv on April 23 found "no statistical evidence" suggesting that a nation's BCG vaccination policy affects it coronavirus infection rates.
Oxford's Viral Vector Vaccine (ChAdOx1-S) (added 5/27/20)
Details: A vaccine in development at the University of Oxford deserves a spot amongst our promising candidates if for nothing else than the remarkable speed at which the researchers are navigating the development process.
After a small monkey study in March delivered encouraging results, the Oxford team quickly moved on to a Phase 1 trial in April. Soon after, they made the bold claim of potentially having "millions" of vaccine doses ready by September.
However, excitement about the vaccine has been tempered by the May 13 publication of the aforementioned monkey study, which noted that the vaccine prevented the animals from contracting pneumonia, but didn't protect them from a coronavirus infection outright.
Timeline: The Oxford researchers have already begun enrolling participants in a combined Phase 2 and 3 trial, which will include children as young as five as well as seniors over the age of 70. The timeframe for those results will depend on how quickly the coronavirus continues to spread in the U.K.
Update, 6/29/20: During a June 26 news briefing, Soumya Swaminathan, the WHO's chief scientist, called ChAdOx1-S "the leading candidate" for a COVID-19 vaccine.
Update, 7/6/20: The Oxford researchers are now testing their vaccine on 5,000 people in Brazil, which has more coronavirus cases than any nation in the world besides the U.S. This marks the first Phase 3 COVID-19 clinical trial in Latin America.
Pfizer's RNA Vaccine (BNT162-01) (added 6/2/20)
Details: Pharma giant Pfizer is developing four mRNA-based coronavirus vaccines with partner BioNTech. On July 1, the duo released the preliminary results of a small trial of one of those vaccines: BNT162-01.
According to the data, the vaccine triggered a strong immune response in study participants who received two doses of the vaccine (24 people), producing antibody levels higher than those of coronavirus survivors.
It also didn't generate any severe side effects, though more than half of the participants who received two doses did report some adverse effects.
Timeline: Pfizer and BioNTech are aiming to launch a combined Phase 2b and 3 trial in July that will involved up to 30,000 participants. The ultimate goal: produce 100 million doses of the vaccine before the end of the year and 1.2 billion in 2021.
The University of Oxford's Rapid Test
Details: All of coronavirus tests currently in use work by isolating COVID-19's RNA from a sample and then turning it into detectable DNA — a process that takes, at best, between 1.5 and 2 hours using complicated machinery.
On March 18, a group of researchers from the University of Oxford announced that they'd developed a test that takes just 30 minutes and doesn't require complicated equipment.
In a lab trial involving 16 patient samples, the test accurately identified the eight that contained the coronavirus and the eight that didn't.
Timeline: The Oxford team is now working on developing hardware that would allow for the deployment of its coronavirus test in hospitals, airports, and even homes.
Biomerica's $10 Serologic Test
Details: Rather than looking for the coronavirus's genetic material in a swabbed sample, Biomerica's COVID-19 test detects antibodies against the virus in a person's blood.
This approach is known as serology testing, and it's beneficial because it can identify people who had the coronavirus, not just those who currently have it — information that could help researchers get a more accurate idea of COVID-19's spread.
Other benefits of Biomerica's disposable COVID-19 IgG/IgM Rapid Test? It can reportedly produce results from a finger prick in just 10 minutes and costs less than $10.
Timeline: On March 18, Biomerica announced that it had begun shipping the coronavirus testing kits to the health ministers of multiple nations for evaluation. It is prepared to fill large international orders of the tests within weeks.
Update, 4/6/20: Biomerica has licensed two of its serological testing technologies for COVID-19 to Mount Sinai’s Icahn School of Medicine in New York. On April 2, it announced plans to file for expedited clearance to begin commercial production of the test, saying it would be capable of manufacturing 1,000,000 tests per month.
4Catalyzer's Smartphone Test
Details: In 2014, biotech entrepreneur Jonathan Rothberg founded 4Catalyzer, a startup accelerator focused on the development of smart medical devices. He's now working with the 4Catalyzer-backed firm Homodeus to develop a smartphone-powered coronavirus test.
According to an interview with IEEE Spectrum, a person will swab their nose and then dip the swab into three test tubes, each containing liquid. The person then snaps a photo of the liquids, which will change color in response to the swab, and uploads it to the 4Catalyzer's in-development smartphone app.
Based on the color of the liquid, the app will be able to tell the person whether they have the coronavirus — all within 20 minutes and without leaving their home.
Timeline: Rothberg said he expects to have prototypes of the test ready to send to academic labs for validation by early April. If all goes well, the tests could be ready for widespread use within months.
Additional Coronavirus Treatments
Additional Coronavirus Vaccines
IMV, Inc. / Canadian Center for Vaccinology at Dalhousie University / Izaak Walton Killam Health Center/ Nova Scotia Health Authority; Canadian Immunization Research Network / University of Laval / Global Urgent and Advanced Research and Development in Canada