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Azelastine Obstructs SARS-CoV-2 In Nasal Tissue In Vitro

Drug repurposing is identifying new indications for existing, clinically approved drugs. With several existing drug candidates being tested to determine their efficacy in fighting COVID-19, so far, the only drug to achieve significant survival benefit is dexamethasone. The team of researchers applied a novel computational prediction approach that is based on biochemical pathways. Their strategy was based on the poly-pharmacological hypothesis that says drugs interact and interfere simultaneously with several different targets and thus rewire the biochemical pathway networks.

Drug identification thus involves finding a drug that matches a pre-defined pathway modulation profile. The team’s initial approach is a description of the inherent chemical properties of small drug molecules, with proven activity against the SARS-CoV-2 virus and implications for specificity to protein targets. Using this unique descriptor, the team identified unexpected or hidden drug similarities and new protein targets in the underlying biochemical pathways. The computational approach helped them ascertain drugs and drug families, some with proven activity and clinical efficacy against SARS-CoV-2.

The results showed that azelastine significantly reduced the cytopathic effect and inhibited SARS-CoV-2 infection of Vero E6 cells both in preventive and treatment settings. They also tested a 5-fold dilution in a commercially available nasal spray. They found that it was very potent in inhibiting the propagation of the SARS-CoV-2 virus in infected human nasal tissue. The team concluded that the antihistamine azelastine might be considered for use in topical prevention or treatment of SARS-CoV-2 nasal colonization. 

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