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

Junhyung Cho1, Young Jae Lee1, Je Hyoung Kim1

  • 1Division of Viral Disease Research, Center for Infectious Diseases Research, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, 187 Osongsaengmyeong 2-ro, Osong-eup, Heungdeok-gu, Cheongju-si, 28159, Chungcheongbuk-do, Republic of Korea.

Scientific Reports
|October 2, 2020
PubMed

Insights

Digoxin and ouabain show significant antiviral activity against SARS-CoV-2, inhibiting over 99% of viral replication. These repurposed heart medications may offer new COVID-19 treatment options, especially for patients with cardiovascular conditions.

Area of Science:

  • Virology
  • Pharmacology
  • Infectious Diseases

Background:

  • The COVID-19 pandemic lacks effective therapeutics, with higher mortality in patients with comorbidities like hypertension and cardiac disease.
  • Drug repurposing is a viable strategy to identify antiviral agents.
  • Digoxin (DIG) and ouabain (OUA), FDA-approved cardiac drugs, exhibit antiviral properties against coronaviruses.

Purpose of the Study:

  • To evaluate the antiviral activity of Digoxin (DIG) and ouabain (OUA) against SARS-CoV-2 infection.
  • To determine the efficacy of DIG and OUA as potential COVID-19 treatments.

Main Methods:

  • Determination of half-maximal inhibitory concentrations (IC50) for DIG and OUA.
  • Assessment of progeny virus titers following single-dose treatment with DIG, OUA, remdesivir, and chloroquine.
  • Evaluation of viral replication inhibition at post-entry stage.

Main Results:

  • DIG and OUA demonstrated antiviral activity at nanomolar concentrations.
  • Single-dose treatment with DIG and OUA reduced viral titers by >99% (10^3- to 10^4-fold) at 48 hours post-infection.
  • Therapeutic treatment with DIG and OUA inhibited over 99% of SARS-CoV-2 replication, acting post-viral entry.

Conclusions:

  • DIG and OUA exhibit potent antiviral effects against SARS-CoV-2.
  • These cardiac drugs represent potential alternative treatments for COVID-19.
  • DIG and OUA may offer additional benefits for COVID-19 patients with cardiovascular disease.

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