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The oral drug nitazoxanide restricts SARS-CoV-2 infection and attenuates disease pathogenesis in Syrian hamsters

Miorin et al., bioRxiv, doi:10.1101/2022.02.08.479634
Feb 2022  
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Syrian hamster study showing improvements in SARS-CoV-2 related weight loss, inflammation, viral load, and lung synctia formation with nitazoxanide, and an In Vitro study showing that nitazoxanide inhibits SARS-CoV-2 in H9, iAT2, Vero E6, Vero TMPRSS2, and Ace2-A549 cells.
3 preclinical studies support the efficacy of nitazoxanide for COVID-19:
2 In Vitro studies Miorin, Riccio
1 In Vivo animal study Miorin
Miorin et al., 9 Feb 2022, preprint, 35 authors.
This PaperNitazoxanideAll
The oral drug nitazoxanide restricts SARS-CoV-2 infection and attenuates disease pathogenesis in Syrian hamsters
Lisa Miorin, Chad E Mire, Shahin Ranjbar, Adam J Hume, Jessie Huang, Nicholas A Crossland, Kris M White, Manon Laporte, Thomas Kehrer, Viraga Haridas, Elena Moreno, Aya Nambu, Sonia Jangra, Anastasija Cupic, Marion Dejosez, Kristine A Abo, Anna E Tseng, Rhiannon B Werder, Raveen Rathnasinghe, Tinaye Mutetwa, Irene Ramos, Julio Sainz De Aja, Carolina Garcia De Alba Rivas, Michael Schotsaert, Ronald B Corley, James V Falvo, Ana Fernandez-Sesma, Carla Kim, Jean-François Rossignol, Andrew A Wilson, Thomas Zwaka, Darrell N Kotton, Elke Mühlberger, Adolfo García-Sastre, Anne E Goldfeld
A well-tolerated and cost-effective oral drug that blocks SARS-CoV-2 growth and dissemination would be a major advance in the global effort to reduce COVID-19 morbidity and mortality. Here, we show that the oral FDA-approved drug nitazoxanide (NTZ) significantly inhibits SARS-CoV-2 viral replication and infection in different primate and human cell models including stem cell-derived human alveolar epithelial type 2 cells. Furthermore, NTZ synergizes with remdesivir, and it broadly inhibits growth of SARS-CoV-2 variants B.1.351 (beta), P.1 (gamma), and B.1617.2 (delta) and viral syncytia formation driven by their spike proteins. Strikingly, oral NTZ treatment of Syrian hamsters significantly inhibits SARS-CoV-2-driven weight loss, inflammation, and viral dissemination and syncytia formation in the lungs. These studies show that NTZ is a novel host-directed therapeutic that broadly inhibits SARS-CoV-2 dissemination and pathogenesis in human and hamster physiological models, which supports further testing and optimization of NTZ-based therapy for SARS-CoV-2 infection alone and in combination with antiviral drugs.
Microscopy Shared Resource Facility at the Icahn School of Medicine at Mount Sinai. We are grateful to Gail Cassell for helpful discussions through the years. Finally, we are indebted to Wallis Annenberg, Jeanne Sullivan, and the founders of Fast Grants for their critical and early support. Conflict of interest The
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