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.
