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. 2020 May 21.
doi: 10.1002/jmv.26030. Online ahead of print.

The Potential of Memantine and Related Adamantanes Such as Amantadine, to Reduce the Neurotoxic Effects of COVID-19, Including ARDS and to Reduce Viral Replication Through Lysosomal Effects

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The Potential of Memantine and Related Adamantanes Such as Amantadine, to Reduce the Neurotoxic Effects of COVID-19, Including ARDS and to Reduce Viral Replication Through Lysosomal Effects

Steven R Brenner. J Med Virol. .

Abstract

SARS-CoV-2 appears to have neurotropic aspects with neurotoxicity through interaction with ACE2 in the medullary brainstem, causing glutamate toxicity in the rostral ventrolateral medulla (RVLM), increased sympathetic tone, hypertension and pulmonary capillary leakage of fluid into the alveoli, resulting in acute respiratory distress syndrome (ARDS). Memantine, a moderate affinity, uncompetitive N-Methyl-D-aspartic acid (NMDA) receptor antagonist which prevents excess calcium entry into cells is commonly utilized in treating patients with Alzheimer's disease, and may inhibit the neurotoxicity induced by SARS-CoV-2 in the medullary brain stem to avoid development of ARDS. Memantine and related adamantine such as amantadine, which is utilized in Parkinson's disease and influenza, may have some anti-viral potential as well. Memantine and similar adamantines may have potential as repurposed medicines for treating Covid19 with inhibition of neurotoxicity, ARDS and viral replication, since Memantine appears to be lysosomotropic. This article is protected by copyright. All rights reserved.

Keywords: ARDS; Memantine; Neurotrophic; SARS-CoV-2; hypertension; neurotoxicity.

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