Innovative, rapid, high-throughput method for drug repurposing in a pandemic – a case study of SARS-CoV-2 and COVID-19

Several efforts to repurpose drugs for COVID-19 treatment have largely either failed to identify a suitable agent or agents identified did not translate to clinical use; either because of demonstrated lack of clinical efficacy in trials, inappropriate dose requirements and probably use of inappropriate pre-clinical laboratory surrogates of effectiveness. In this study, we used an innovative algorithm, that incorporates dissemination and implementation considerations, to identify potential drugs for COVID-19 using iterative computational and wet laboratory methods that highlight inhibition of viral induced cytopathic effect (CPE) as a laboratory surrogate of effectiveness. Erythromycin, pyridoxine, folic acid and retapamulin were found to inhibit SARS-CoV-2 induced CPE in Vero cells at concentrations that are clinically achievable. Additional studies may be required to further characterize the inhibitions of CPE and the possible mechanisms. Funding TETFund Covid-19 Special Intervention Research grant(grant number TETFund/DR&D/CE/ SI/COVID-19/UDUS/VOL 1)