The serotonin reuptake inhibitor Fluoxetine inhibits SARS-CoV-2 in human lung tissue

Sci Rep. 2021 Mar 15;11(1):5890. doi: 10.1038/s41598-021-85049-0.

Abstract

To circumvent time-consuming clinical trials, testing whether existing drugs are effective inhibitors of SARS-CoV-2, has led to the discovery of Remdesivir. We decided to follow this path and screened approved medications "off-label" against SARS-CoV-2. Fluoxetine inhibited SARS-CoV-2 at a concentration of 0.8 µg/ml significantly in these screenings, and the EC50 was determined with 387 ng/ml. Furthermore, Fluoxetine reduced viral infectivity in precision-cut human lung slices showing its activity in relevant human tissue targeted in severe infections. Fluoxetine treatment resulted in a decrease in viral protein expression. Fluoxetine is a racemate consisting of both stereoisomers, while the S-form is the dominant serotonin reuptake inhibitor. We found that both isomers show similar activity on the virus, indicating that the R-form might specifically be used for SARS-CoV-2 treatment. Fluoxetine inhibited neither Rabies virus, human respiratory syncytial virus replication nor the Human Herpesvirus 8 or Herpes simplex virus type 1 gene expression, indicating that it acts virus-specific. Moreover, since it is known that Fluoxetine inhibits cytokine release, we see the role of Fluoxetine in the treatment of SARS-CoV-2 infected patients of risk groups.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antiviral Agents / pharmacology*
  • Antiviral Agents / therapeutic use
  • COVID-19 / virology*
  • COVID-19 Drug Treatment
  • Cell Line
  • Cells, Cultured
  • Fluoxetine / pharmacology*
  • Fluoxetine / therapeutic use
  • Humans
  • Lung / drug effects*
  • Lung / pathology
  • Lung / virology*
  • SARS-CoV-2 / drug effects*
  • Selective Serotonin Reuptake Inhibitors / pharmacology*
  • Selective Serotonin Reuptake Inhibitors / therapeutic use
  • Virus Replication / drug effects

Substances

  • Antiviral Agents
  • Serotonin Uptake Inhibitors
  • Fluoxetine