Drug Repositioning For The Prophylaxis And Treatment Of Covid-19

Abstract

Coronaviruses are large, enveloped, single-stranded, positive-sense RNA viruses and belong to the family coronaviridae. Other viruses from the same family include the severe acute respiratory syndrome coronavirus (SARS-CoV), which appeared in 2002 in China, and Middle East respiratory syndrome coronavirus (MERS-CoV ), which appeared in 2012 in Saudi Arabia. In december 2019, several patients from Wuhan, China were admitted with symptoms of pneumonia. A new virus was identified and initially called the 2019 novel coronavirus (2019-nCoV). On january 30, 2020, the World Health Organization (WHO) named the disease as “COVID-19” which is coronavirus disease 2019. On March 11, 2020, the WHO described its outbreak as a pandemic. Chloroquine (CQ), the antimalarial drug, elicit antiviral effects against several viruses. Previous studies reported the 
antiviral activity of CQ against many human coronaviruses (HCoVs) such as SARS-CoV, MERS-CoV, and HCoV-OC43. Recent in vitro studies (2020) reported that CQ and hydroxychloroquine (HCQ) is effective in inhibiting SARS-CoV-2 infection. In China, in February 2020 over 100 patients treated with (CQ) resulted in significant improvement of pneumonia. In France, on March 17, 2020, some of the COVID-19 patients were treated with (HCQ) and others treated with HCQ in combination with azithromycin to prevent bacterial infection. It is well known that Nigella sativa can prevent and treat many diseases including various viral diseases and it has been shown that its adjunct use with CQ gives better results in treating malaria in comparison with CQ alone.  Therefore, we suggest the use of Nigella sativa as an adjunct with HCQ to treat COVID-19 , which can potentiate its effect 
and reduces its toxicity. Furthermore, as HCQ concentrates more in the lung tissue and remains for about weeks, therefore it could be used as a prophylaxis to prevent COVID-19 infection.