Repositioned Drugs for COVID-19-the Impact on Multiple Organs

Abstract

This review summarizes published findings of the beneficial and harmful effects on the heart, lungs, immune system, kidney, liver, and central nervous system of 47 drugs that have been proposed to treat COVID-19. Many of the repurposed drugs were chosen for their benefits to the pulmonary system, as well as immunosuppressive and anti-inflammatory effects. However, these drugs have mixed effects on the heart, liver, kidney, and central nervous system. Drug treatments are critical in the fight against COVID-19, along with vaccines and public health protocols. Drug treatments are particularly needed as variants of the SARS-Cov-2 virus emerge with some mutations that could diminish the efficacy of the vaccines. Patients with comorbidities are more likely to require hospitalization and greater interventions. The combination of treating severe COVID-19 symptoms in the presence of comorbidities underscores the importance of understanding the effects of potential COVID-19 treatments on other organs.

Supplementary information: The online version contains supplementary material available at 10.1007/s42399-021-00874-8.

Keywords: COVID-19; Central nervous system; Drug repositioning; Heart; Immune system; Kidneys; Liver; Lungs.

Fig. 1

The effects of certain drugs on the immune system and individual organs (lungs, heart, kidneys, liver, and CNS)

Fig. 2

Chloroquine (CQ) and remdesivir (RDV) influence human heart organoid beat rate. Beat rate (per minute) was assessed following 96 h of treatment. Heart organoids were treated with either a CQ (n = 3, control; n = 4, 10 μM and 100 μM) or b RDV (n = 4 for all conditions) at concentrations of 10 μM or 100 μM for 96 h. Beats per min (BPM) in the treatment conditions were normalized to BPM in the pre-treatment condition for each individual organoid in each condition. (Value = mean ± s.d., two-way ANOVA multiple comparison test; *p = 0.0571, **p < 0.01, ****p < 0.0001)

Fig. 3

CQ and RDV induce QT interval prolongation in human heart organoids.Using the electrophysiological data obtained with the MEA system, QT intervals were measured in organoids with or without treatment of a CQ or b RDV. (value = mean ± SEM, one-way ANOVA multiple comparison test, compared to control; *p < 0.05, ** p < 0.005)