Internal medicine

Organic chemistry

Virus

Digoxin

Heart failure

Disease

Antiviral drug

Coronavirus disease 2019 (COVID-19)

Infectious disease (medical specialty)

Biology

Pandemic

Viral replication

Molecular biology

Virology

Chemistry

Immunology

Malaria

Chloroquine

Coronavirus

Ouabain

Drug

Sodium

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)

Medicine

Pharmacology

Scientific Reports

The current coronavirus (COVID-19) pandemic is exacerbated by the absence of effective therapeutic agents. Notably, patients with COVID-19 and comorbidities such as hypertension and cardiac diseases have a higher mortality rate. An efficient strategy in response to this issue is repurposing drugs with antiviral activity for therapeutic effect. Digoxin (DIG) and ouabain (OUA) are FDA drugs for heart diseases that have antiviral activity against several coronaviruses. Thus, we aimed to assess antiviral activity of DIG and OUA against SARS-CoV-2 infection. The half-maximal inhibitory concentrations (IC 50 ) of DIG and OUA were determined at a nanomolar concentration. Progeny virus titers of single-dose treatment of DIG, OUA and remdesivir were approximately 10 3 -, 10 4 - and 10 3 -fold lower (&gt; 99% inhibition), respectively, than that of non-treated control or chloroquine at 48 h post-infection (hpi). Furthermore, therapeutic treatment with DIG and OUA inhibited over 99% of SARS-CoV-2 replication, leading to viral inhibition at the post entry stage of the viral life cycle. Collectively, these results suggest that DIG and OUA may be an alternative treatment for COVID-19, with potential additional therapeutic effects for patients with cardiovascular disease.

Antiviral activity of digoxin and ouabain against SARS-CoV-2 infection and its implication for COVID-19