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Background: Amantadine has been proposed as a treatment for COVID-19 because it shows anti-SARS-CoV-2 activity in vitro. However, to date, no controlled study has assessed the safety and efficacy of amantadine in COVID-19., Research Question: Whether amantadine is effective and safe among patients with different COVID-19 severity classifications., Study Design: and Methods: This was multi-centre, randomised, placebo-controlled study.Patients with oxygen saturation ≤94% and no need for high-flow oxygen or ventilatory support were randomly allocated to receive oral amantadine or placebo (1:1) for 10 days in addition to standard care. The primary endpoint was time to recovery assessed over 28 days since randomisation, defined as discharge from hospital or no need for supplemental oxygen., Results: The study was terminated early due to a lack of efficacy after an interim analysis. Final data from 95 patients who received amantadine (mean age, 60.2 years; 65% male; 66% with comorbidities) and 91 patients who received placebo (mean age, 55.8 years; 60% male; 68% with comorbidities) were obtained. The median (95% CI) time to recovery was 10 days both in the amantadine (9-11) and placebo arms (8-11; subhazard ratio = 0.94 [95%CI 0.7-1.3]). The percentage of deaths and percentage of patients who required intensive care at 14 and 28 days did not significantly differ between the amantadine and placebo groups., Interpretation: Adding amantadine to standard care in patients hospitalised with COVID-19 did not increase the likelihood of recovery., Clinical Trial Registration: ClinicalTrials.gov; No.: NCT04952519; www., Clinicaltrials: gov., (Copyright © 2023. Published by Elsevier Ltd.)

Coronavirus disease 19 (COVID-19) rapidly spread worldwide. The search for effective measures to counter the development and effects of the pandemic includes: identifying the disease pathogen, introducing methods of reducing its transmission, building the population immunity, and the search for a cure, both among the new and already-known substances with potential antivirus activity such as amantadine hydrochloride., Aim: The aim of the study was an observational single-center analysis of confirmed COVID-19 cases treated with amantadine in ambulatory settings., Materials and Methods: The 55 patients with confirmed COVID-19 diagnosis were treated in ambulatory settings by amantadine with a treatment schema varied from 200 mg to 500 mg per day. A retrospective analysis was based on symptoms, hospitalization, and number of deaths., Results: The mean age of the patients was 55.9 years (SD=15), and most patients were male (60%). Despite the majority of patients 64% (n=35) suffering from comorbidities and 53% (n=29) of patients having been diagnosed with pneumonia, none of them died, and only four had required hospitalization in the course of COVID-19. Clinical stabilization was achieved in 91% (n=50) of patients within 48 hours after the first dose of amantadine with further improvement; additionally, all patients experienced remission of COVID-19. In total, 93% (n=51) of patients did not require hospitalization during the treatment., Conclusions: The data may suggest that amantadine hydrochloride shows efficacy in preventing hospitalization and deaths in patients with COVID-19. At the same time, it emphasizes that daily monitoring of the patient and regular examination are important in the case of SARS-CoV-2 infection dynamics. It may be justified to carry out a prospective, randomized, and double-blinded clinical study with the postulated amantadine scheme., (© 2021 MEDPRESS.)