Taming the cytokine storm: repurposing montelukast for the attenuation and prophylaxis of severe COVID-19 symptoms

Drug Discov Today. 2020 Dec;25(12):2076-2079. doi: 10.1016/j.drudis.2020.09.013. Epub 2020 Sep 16.


As a result of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections, a clinical complication can arise that is characterized by a hyperinflammatory cytokine profile, often termed a 'cytokine storm'. A protein complex (nuclear factor kappa-light-chain-enhancer of activated B cells; NF-κB) is intricately involved in regulating inflammation and the immune response following viral infections, with a reduction in cytokine production often observed following a decrease in NF-κB activity. An approved asthma drug, montelukast, has been found to modulate the activity of NF-κB, and result in a corresponding decrease in proinflammatory mediators. Herein, we hypothesize that repurposing montelukast to suppress NF-κB activation will result in an attenuation of proinflammatory mediators and a decrease in cytokine production, thereby leading to a reduction in symptom severity and to improved clinical outcomes in patients with Coronavirus 2019 (COVID-19).

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetates / therapeutic use*
  • Age Factors
  • COVID-19 / immunology
  • COVID-19 Drug Treatment*
  • Cyclopropanes
  • Cytokine Release Syndrome / drug therapy*
  • Cytokine Release Syndrome / immunology
  • Cytokines / immunology*
  • Drug Repositioning
  • Humans
  • Leukotriene Antagonists / therapeutic use*
  • NF-kappa B / immunology*
  • Obesity / immunology
  • Quinolines / therapeutic use*
  • Respiratory Distress Syndrome / immunology
  • Respiratory Distress Syndrome / therapy*
  • Severity of Illness Index
  • Sex Factors
  • Signal Transduction / immunology
  • Sulfides


  • Acetates
  • Cyclopropanes
  • Cytokines
  • Leukotriene Antagonists
  • NF-kappa B
  • Quinolines
  • Sulfides
  • montelukast