Is Inhaled Furosemide a Potential Therapeutic for COVID-19?

Am J Med Sci. 2020 Sep;360(3):216-221. doi: 10.1016/j.amjms.2020.05.044. Epub 2020 Jun 1.

Abstract

The potentially lethal infection caused by the novel Severe Acute Respiratory Disease Coronavirus-2 (SARS-CoV-2) has evolved into a global crisis. Following the initial viral infection is the host inflammatory response that frequently results in excessive secretion of inflammatory cytokines (e.g., IL-6 and TNFα), developing into a self-targeting, toxic "cytokine storm" causing critical pulmonary tissue damage. The need for a therapeutic that is available immediately is growing daily but the de novo development of a vaccine may take years. Therefore, repurposing of approved drugs offers a promising approach to address this urgent need. Inhaled furosemide, a small molecule capable of inhibiting IL-6 and TNFα, may be an agent capable of treating the Coronavirus Disease 2019 cytokine storm in both resource-rich and developing countries. Furosemide is a "repurpose-able" small molecule therapeutics, that is safe, easily synthesized, handled, and stored, and is available in reasonable quantities worldwide.

Keywords: COVID-19; Cytokine storm; Furosemide; IL-6; SARS-CoV-2.

Publication types

  • Review

MeSH terms

  • Administration, Inhalation
  • Antiviral Agents / administration & dosage
  • Antiviral Agents / pharmacokinetics
  • Betacoronavirus / drug effects*
  • Betacoronavirus / immunology
  • Betacoronavirus / metabolism
  • COVID-19
  • Coronavirus Infections / drug therapy*
  • Coronavirus Infections / immunology
  • Coronavirus Infections / metabolism
  • Furosemide / administration & dosage*
  • Furosemide / pharmacokinetics
  • Humans
  • Immunity, Innate / drug effects*
  • Immunity, Innate / physiology
  • Inflammation Mediators / antagonists & inhibitors
  • Inflammation Mediators / immunology
  • Inflammation Mediators / metabolism
  • Pandemics
  • Pneumonia, Viral / drug therapy*
  • Pneumonia, Viral / immunology
  • Pneumonia, Viral / metabolism
  • SARS-CoV-2
  • Sodium Potassium Chloride Symporter Inhibitors / administration & dosage
  • Sodium Potassium Chloride Symporter Inhibitors / pharmacokinetics

Substances

  • Antiviral Agents
  • Inflammation Mediators
  • Sodium Potassium Chloride Symporter Inhibitors
  • Furosemide