Thalidomide against Coronavirus Disease 2019 (COVID-19): A Medicine with a Thousand Faces

Authors

1 Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

2 Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.

3 Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

4 Virology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

5 Student Research Committee, Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Abstract

Recently, Wuhan, China became the epicenter for the outbreak of novel coronavirus pneumonia (COVID-19). No specific agents are available for treating COVID-19 while some agents such as antivirals, chloroquine, and immunomodulatory agents are under investigation.
In vitro and in vivo studies showed that thalidomide impairs the synthesis of tumor necrosis factor alpha (TNF-alpha). It increases peripheral blood CD8+ T cells, plasma interleukin 12 (IL-12) levels, interferon-γ production, and cytotoxic activity. Anti-inflammatory effects of thalidomide on H1N1 influenza virus-induced pulmonary injury in mice showed that thalidomide greatly improves the survival rate, reduces the infiltration of inflammatory cells, cytokine (e.g., IL-6, TNF-α), and chemokine (chemokine ligand 5, C-X-C motif chemokine 10) levels, and inhibits the activated p-NFκB p6. Given the beneficial effects of thalidomide, it is necessary to try it in COVID-19 cases as a therapeutic agent. It is recommended that large clinical trials be designed to find the efficacy and safety of thalidomide in COVID-19.

Graphical Abstract

Thalidomide against Coronavirus Disease 2019 (COVID-19): A Medicine with a Thousand Faces

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