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Observational Study
. 2021 Oct 28;16(10):e0259061.
doi: 10.1371/journal.pone.0259061. eCollection 2021.

Disulfiram use is associated with lower risk of COVID-19: A retrospective cohort study

Nathanael Fillmore  1   2 , Steven Bell  3 , Ciyue Shen  4   5   6 , Vinh Nguyen  1 , Jennifer La  1 , Maureen Dubreuil  7   8 , Judith Strymish  2   9 , Mary Brophy  1   10 , Gautam Mehta  11   12 , Hao Wu  13   14 , Judy Lieberman  14   15 , Nhan Do  1   16 , Chris Sander  4   5   6
Affiliations
Observational Study

Disulfiram use is associated with lower risk of COVID-19: A retrospective cohort study

Nathanael Fillmore et al. PLoS One. .

Abstract

Effective, low-cost therapeutics are needed to prevent and treat COVID-19. Severe COVID-19 disease is linked to excessive inflammation. Disulfiram is an approved oral drug used to treat alcohol use disorder that is a potent anti-inflammatory agent and an inhibitor of the viral proteases. We investigated the potential effects of disulfiram on SARS-CoV-2 infection and disease severity in an observational study using a large database of clinical records from the national US Veterans Affairs healthcare system. A multivariable Cox regression adjusted for demographic information and diagnosis of alcohol use disorder revealed a reduced risk of SARS-CoV-2 infection with disulfiram use at a hazard ratio of 0.66 (34% lower risk, 95% confidence interval 24-43%). There were no COVID-19 related deaths among the 188 SARS-CoV-2 positive patients treated with disulfiram, in contrast to 5-6 statistically expected deaths based on the untreated population (P = 0.03). Our epidemiological results suggest that disulfiram may contribute to the reduced incidence and severity of COVID-19. These results support carefully planned clinical trials to assess the potential therapeutic effects of disulfiram in COVID-19.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Population distribution of the patient cohort used for the study.
944,127 Veterans have at least one SARS-CoV-2 laboratory test result between Feb. 20, 2020 and Feb. 1, 2021, and had visited a VA primary care provider in the 18 months before their first SARS-CoV-2 test. Disulfiram + (-) indicates at least one (no) pharmacy record for disulfiram on or after Feb. 20, 2019. COVID19 + (-) indicates a positive (no positive) SARS-CoV-2 laboratory test.
See this image and copyright information in PMC

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