COVID-19 is the disease caused by SARS-CoV-2 which has led to 2,643,000 deaths worldwide, a number which is rapidly increasing. Urgent studies to identify new
antiviral drugs, repurpose existing drugs, or identify drugs that can target the overactive immune response are ongoing. Antiretroviral drugs (ARVs) have been tested in past human
coronavirus infections, and also against SARS-CoV-2, but a trial of
lopinavir and ritonavir failed to show any clinical benefit in
COVID-19. However, there is limited data as to the course of
COVID-19 in people living with HIV, with some studies showing a decreased mortality for those taking certain ARV regimens. We hypothesized that ARVs other than
lopinavir and ritonavir might be responsible for some protection against the progression of
COVID-19. Here, we used chemoinformatic analyses to predict which ARVs would bind and potentially inhibit the
SARS-CoV-2 main protease (Mpro) or
RNA-dependent-RNA-polymerase (RdRp)
enzymes in silico. The drugs predicted to bind the SARS-CoV-2 Mpro included the
protease inhibitors atazanavir and
indinavir. The ARVs predicted to bind the catalytic site of the RdRp included
Nucleoside Reverse Transcriptase Inhibitors,
abacavir,
emtricitabine,
zidovudine, and
tenofovir. Existing or new combinations of antiretroviral drugs could potentially prevent or ameliorate the course of
COVID-19 if shown to inhibit SARS-CoV-2 in vitro and in clinical trials. Further studies are needed to establish the activity of ARVs for treatment or prevention of
SARS-CoV-2 infection .Communicated by Ramaswamy H. Sarma.