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Cyclosporine and COVID-19: Risk or favorable?

Nadia Nicholine Poulsen1, Albrecht von Brunn2, Mads Hornum3,4

  • 1Department of Growth and Reproduction, Group of Skeletal, Mineral, and Gonadal Endocrinology, Rigshospitalet, Copenhagen, Denmark.

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
|August 11, 2020
PubMed

Insights

Cyclosporine shows potential in inhibiting SARS-CoV-2 replication in vitro, offering a possible avenue for COVID-19 treatment. However, clinical evidence for its effectiveness against severe COVID-19 is still pending.

Area of Science:

  • Virology
  • Immunology
  • Pharmacology

Background:

  • The COVID-19 pandemic, caused by SARS-CoV-2, presents a significant global health challenge.
  • While risk factors like obesity and diabetes are known, the susceptibility of immunosuppressed patients to severe COVID-19 remains under investigation.
  • Current research focuses on identifying drugs to mitigate COVID-19's mortality and societal burden.

Purpose of the Study:

  • To review the potential link between cyclosporine and COVID-19.
  • To explore the in vitro efficacy of cyclosporine and its analog, alisporivir, against coronaviruses.
  • To assess the current lack of clinical evidence for cyclosporine's protective effects in COVID-19 patients.

Main Methods:

  • Literature review of existing studies on cyclosporine and coronavirus replication.
  • Analysis of in vitro data demonstrating cyclosporine's antiviral activity.
  • Examination of clinical trial data and observational studies concerning COVID-19 and immunosuppression.

Main Results:

  • Cyclosporine has demonstrated in vitro inhibition of replication for various coronaviruses.
  • Alisporivir, a cyclosporine analog, has shown in vitro inhibition of SARS-CoV-2.
  • No clinical evidence currently supports cyclosporine's protective effect against severe COVID-19 or its complications like ARDS.

Conclusions:

  • Cyclosporine's in vitro antiviral activity against coronaviruses is promising.
  • Further robust clinical data is required to establish the efficacy of cyclosporine in preventing or treating COVID-19.
  • The potential role of cyclosporine in managing COVID-19-related immune responses warrants continued investigation.

Keywords:
clinical research/practiceimmunosuppressant - calcineurin inhibitor (CNI)immunosuppression/immune modulationinfection and infectious agents - viralinfectious diseaseorgan transplantation in general

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