The Potential for Repurposing Anti-TNF as a Therapy for the Treatment of COVID-19

Abstract

Coronavirus disease 2019 (COVID-19) currently has few effective treatments. Given the uncertainty surrounding the effectiveness and uptake of a vaccine, it is important that the search for treatments continue. An exaggerated inflammatory state is likely responsible for much of the morbidity and mortality in COVID-19. Elevated levels of tumor necrosis factor (TNF), a key pro-inflammatory cytokine, have been shown to be associated with increased COVID-19 mortality. In patients with rheumatoid arthritis, TNF blockade reduces not only biologically active TNF but other pro-inflammatory cytokines important in COVID-19 hyperinflammation. Observational data from patients already on anti-TNF therapy show a reduced rate of COVID-19 poor outcomes and death compared with other immune-suppressing therapies. Anti-TNF has a long history of safe use, including in special at-risk populations, and is widely available. The case to adequately assess anti-TNF as a treatment for COVID-19 is compelling.

Keywords: SARS-CoV-2; coronavirus disease-2019; glucocorticoids; pandemic; tumor necrosis factor.

Figure 1

Survival Over 12 Days of BALB/c Mice Intranasally Infected with 3 × 10⁴ Plaque-Forming Units of SARS-CoV and Then Given Either Anti-TNF or Rat IgG Isotype Control From Channappanavar et al.