Journal of Pharmaceutics & Pharmacology

Research Article

Potential for the Use of Adamantanes for the Prevention and Treatment of the Neurological Complications of COVID-19

Butterworth Roger F*

University of Montreal, Canada
*Address for Correspondence: Butterworth Roger F, Professor of Medicine, University of Montreal, 45143 Cabot Trail, Englishtown, NS, B0C 1H0, Canada; E-mail: rb@enceph.com
Submission: 22 August 2020; Accepted: 02 October 2020; Published: 12 October 2020
Copyright: © 2020 Butterworth Roger F. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Widespread damage to the central and peripheral nervous systems resulting from COVID-19 is becoming well established. Features include impairments of the level [somnolence, stupor, coma] and content [confusion, delirium] of consciousness, impaired senses of taste, smell and vision as well as skeletal muscle manifestations. The neuroinvasive nature of SARS-CoV-2 may contribute to the acute respiratory failure of COVID-19. SARS-CoV-1 virus was detected in the brain of infected patients along with neuronal necrosis and glial hyperplasia. In SARS-CoV-2, modifications of crucial cellular pathways [mitochondrial function, proteolysis, lipid metabolism] known to be implicated in cellular aging and in neurodegenerative diseases occur. Adamantanes, [amantadine and the structurally-related memantine] are employed for the treatment of disorders of consciousness while also manifesting effective antiviral properties. Clinical studies and Case Reports at this early stage of COVID-19 reveal evidence of a protective effect of amantadine in infected patients with benefit being ascribed to amantadine’s effects on viral release into the host cell via mechanisms involving the E channel of the virus or by the agent’s down-regulation of the host protease Cathepsin L in addition to disruption of the lysosomal pathway. Memantine has potent neuroprotective actions in both wellestablished neurodegenerative diseases as well as in viral disorders in which it prevents neuronal cell loss and concomitantly reduces viral replication in a dose-dependent manner. Controlled clinical trials for the assessment of efficacy of these adamantanes for the prevention and treatment of COVID-19 are now indicated.