Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Apr;59(4):780-786.
doi: 10.1080/02770903.2021.1881967. Epub 2021 Mar 4.

Montelukast in hospitalized patients diagnosed with COVID-19

Ahsan R Khan  1 , Christian Misdary  1 , Nikhil Yegya-Raman  2 , Sinae Kim  1   3 , Navaneeth Narayanan  4   5 , Sheraz Siddiqui  5 , Padmini Salgame  6 , Jared Radbel  5 , Frank De Groote  7 , Carl Michel  1 , Janice Mehnert  8 , Caleb Hernandez  9   10 , Thomas Braciale  10   11 , Jyoti Malhotra  1   5 , Michael A Gentile  11   12 , Salma K Jabbour  1   5
Affiliations

Montelukast in hospitalized patients diagnosed with COVID-19

Ahsan R Khan et al. J Asthma. 2022 Apr.

Abstract

Objective: Several therapeutic agents have been assessed for the treatment of COVID-19, but few approaches have been proven efficacious. Because leukotriene receptor antagonists, such as montelukast have been shown to reduce both cytokine release and lung inflammation in preclinical models of viral influenza and acute respiratory distress syndrome, we hypothesized that therapy with montelukast could be used to treat COVID-19. The objective of this study was to determine if montelukast treatment would reduce the rate of clinical deterioration as measured by the COVID-19 Ordinal Scale.

Methods: We performed a retrospective analysis of COVID-19 confirmed hospitalized patients treated with or without montelukast. We used "clinical deterioration" as the primary endpoint, a binary outcome defined as any increase in the Ordinal Scale value from Day 1 to Day 3 of the hospital stay, as these data were uniformly available for all admitted patients before hospital discharge. Rates of clinical deterioration between the montelukast and non-montelukast groups were compared using the Fisher's exact test. Univariate logistic regression was also used to assess the association between montelukast use and clinical deterioration. A total of 92 patients were analyzed, 30 who received montelukast at the discretion of the treating physician and 62 patients who did not receive montelukast.

Results: Patients receiving montelukast experienced significantly fewer events of clinical deterioration compared with patients not receiving montelukast (10% vs 32%, p = 0.022). Our findings suggest that montelukast associates with a reduction in clinical deterioration for COVID-19 confirmed patients as measured on the COVID-19 Ordinal Scale.

Conclusions: Hospitalized COVID-19 patients treated with montelukast had fewer events of clinical deterioration, indicating that this treatment may have clinical activity. While this retrospective study highlights a potential pathway for COVID-19 treatment, this hypothesis requires further study by prospective studies.

Keywords: COVID-19; hypoxemia; leukotriene; montelukast; viral infection.

PubMed Disclaimer

Conflict of interest statement

No financial/nonfinancial disclosures except: CH is the Chairman and CEO of Certa Dose, Inc. Neither CH nor Certa Dose have any financial interests in the sale of Montelukast or any companies that manufacture Montelukast. JM, Research funding: BMS, Beyond Spring, Celldex, Biohaven; Advisory board: Astra Zeneca. MG is a Director of Scientific Affairs at Merck. Merck manufactures Singulair®, which is available as generic montelukast. SKJ receives research funding and personal fees from Merck, unrelated to this work.

References

    1. Fidan C, Aydoğdu A.. As a potential treatment of COVID-19: Montelukast. Med Hypotheses. 2020;142:109828. doi:10.1016/j.mehy.2020.109828. - DOI - PMC - PubMed
    1. Guan W-J, Ni Z-Y, Hu Y, Liang W-H, Ou C-Q, He J-X, Liu L, Shan H, Lei C-L, Hui DSC, China Medical Treatment Expert Group for Covid-19, et al.. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708–1720. doi:10.1056/nejmoa2002032. - DOI - PMC - PubMed
    1. Chen G, Wu D, Guo W, Cao Y, Huang D, Wang H, Wang T, Zhang X, Chen H, Yu H, et al. . Clinical and immunological features of severe and moderate coronavirus disease 2019. J Clin Invest. 2020;130(5):2620–2629. doi:10.1172/JCI137244. - DOI - PMC - PubMed
    1. Pedersen SF, Ho YC.. SARS-CoV-2: a storm is raging. J Clin Invest. 2020;130(5):2202–2205. doi:10.1172/JCI137647. - DOI - PMC - PubMed
    1. Mason RJ. Pathogenesis of COVID-19 from a cell biology perspective. Eur Respir J. 2020;55(4):2000607. doi:10.1183/13993003.00607-2020. - DOI - PMC - PubMed