Pharmaceuticals (Basel) . FDA-Approved Drugs with Potent In Vitro Antiviral Activity against Severe Acute Respiratory Syndrome Coronavirus 2

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Pharmaceuticals (Basel)


. 2020 Dec 4;13(12):E443.
doi: 10.3390/ph13120443.
FDA-Approved Drugs with Potent In Vitro Antiviral Activity against Severe Acute Respiratory Syndrome Coronavirus 2


Ahmed Mostafa ¹ , Ahmed Kandeil ¹ , Yaseen A M M Elshaier ² , Omnia Kutkat ¹ , Yassmin Moatasim ¹ , Adel A Rashad ³ , Mahmoud Shehata ¹ , Mokhtar R Gomaa ¹ , Noura Mahrous ¹ , Sara H Mahmoud ¹ , Mohamed GabAllah ¹ , Hisham Abbas ⁴ , Ahmed El Taweel ¹ , Ahmed E Kayed ¹ , Mina Nabil Kamel ¹ , Mohamed El Sayes ¹ , Dina B Mahmoud ⁵ , Rabeh El-Shesheny ¹ , Ghazi Kayali ^{6 7} , Mohamed A Ali ¹



Affiliations

• PMID: 33291642
• DOI: 10.3390/ph13120443

Abstract

(1) Background: Drug repositioning is an unconventional drug discovery approach to explore new therapeutic benefits of existing drugs. Currently, it emerges as a rapid avenue to alleviate the COVID-19 pandemic disease. (2) Methods: Herein, we tested the antiviral activity of anti-microbial and anti-inflammatory Food and Drug Administration (FDA)-approved drugs, commonly prescribed to relieve respiratory symptoms, against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the viral causative agent of the COVID-19 pandemic. (3) Results: Of these FDA-approved antimicrobial drugs, Azithromycin, Niclosamide, and Nitazoxanide showed a promising ability to hinder the replication of a SARS-CoV-2 isolate, with IC₅₀ of 0.32, 0.16, and 1.29 ?M, respectively. We provided evidence that several antihistamine and anti-inflammatory drugs could partially reduce SARS-CoV-2 replication in vitro. Furthermore, this study showed that Azithromycin can selectively impair SARS-CoV-2 replication, but not the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). A virtual screening study illustrated that Azithromycin, Niclosamide, and Nitazoxanide bind to the main protease of SARS-CoV-2 (Protein data bank (PDB) ID: 6lu7) in binding mode similar to the reported co-crystalized ligand. Also, Niclosamide displayed hydrogen bond (HB) interaction with the key peptide moiety GLN: 493A of the spike glycoprotein active site. (4) Conclusions: The results suggest that Piroxicam should be prescribed in combination with Azithromycin for COVID-19 patients.

Keywords: COVID-19; SARS-CoV-2; antiviral; drug repurposing; virtual screening.