1. Antiviral Potential of the Antimicrobial Drug Atovaquone against SARS-CoV-2 and Emerging Variants of Concern
- Author
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Martin R. Jakobsen, Jean-Simon Diallo, Anne Louise Hansen, Taha Azad, Luc A. Sabourin, David Jacobs, Manja Idorn, Geneviève Laroche, Julien van Grevenynghe, Renée M. van der Sluis, Glib Maznyi, Jean Seguin, Fanghui Ren, Daniele Di Carlo, Rozanne Arulanandam, Ragunath Singaravelu, Kathy Fu, David Olagnier, Tommy Alain, Christian K. Holm, Søren R. Paludan, John C. Bell, Marceline Côté, John Hiscott, Demi van der Horst, Naziia Kurmasheva, Lena Cassin, Enrico Palermo, Madalina E. Carter-Timofte, and Zaid Taha
- Subjects
Drug ,Proguanil ,media_common.quotation_subject ,coronavirus ,virus ,Azithromycin ,Antiviral Agents ,Article ,03 medical and health sciences ,medicine ,Humans ,030304 developmental biology ,media_common ,0303 health sciences ,variants ,drug repurposing ,030306 microbiology ,business.industry ,SARS-CoV-2 ,COVID-19 ,medicine.disease ,Antimicrobial ,atovaquone ,Virology ,United States ,3. Good health ,Drug repositioning ,Infectious Diseases ,Chemoprophylaxis ,business ,Atovaquone ,Malaria ,medicine.drug - Abstract
The antimicrobial medication malarone (atovaquone/proguanil) is used as a fixed-dose combination for treating children and adults with uncomplicated malaria or as chemoprophylaxis for preventing malaria in travelers. It is an inexpensive, efficacious, and safe drug frequently prescribed around the world. Following anecdotal evidence from 17 patients in the provinces of Quebec and Ontario, Canada, suggesting that malarone/atovaquone may present some benefits in protecting against COVID-19, we sought to examine its antiviral potential in limiting the replication of SARS-CoV-2 in cellular models of infection. In VeroE6 expressing human TMPRSS2 and human lung Calu-3 epithelial cells, we show that the active compound atovaquone at micromolar concentrations potently inhibits the replication of SARS-CoV-2 and other variants of concern including the alpha, beta, and delta variants. Importantly, atovaquone retained its full antiviral activity in a primary human airway epithelium cell culture model. Mechanistically, we demonstrate that the atovaquone antiviral activity against SARS-CoV-2 is partially dependent on the expression of TMPRSS2 and that the drug can disrupt the interaction of the spike protein with the viral receptor, ACE2. Additionally, spike-mediated membrane fusion was also reduced in the presence of atovaquone. In the United States, two clinical trials of atovaquone administered alone or in combination with azithromycin were initiated in 2020. While we await the results of these trials, our findings in cellular infection models demonstrate that atovaquone is a potent antiviral FDA-Approved drug against SARS-CoV-2 and other variants of concern in vitro.
- Published
- 2021