As the world races to find a treatment for SARS-CoV-2 (coronavirus), cases continue to rise. The virus first shot to headline news status in late 2019 as the death toll rose in China, and it has been dominating the worldwide news ever since. At the time of writing, over three million cases have been confirmed across the globe.
The prevalence of the virus mimics that of both MERS (Middle Eastern Respiratory Syndrome) and SARS (Severe Acute Respiratory Syndrome), both of which gained health emergency status in the early 2000s. Even though all three belong to the coronavirus family of viruses, there are some stark differences in terms of how big a public health threat they are. The similarities lie in how the virus affects the body, but the differences lie in how dangerous each virus could be. In the SARS and MERS outbreaks, fewer than 2,000 people perished, with the death tolls from SARS and MERS being 812 and 866 respectively.
Compared to the brutally high numbers of confirmed cases of SARS-CoV-2, both SARS and MERS seem to be the inferior strains of the virus, but with MERS having a 34.3% mortality rate and SARS 9.6%, the SARS-CoV-2 mortality rate of only 1.4–3.4% makes it much less deadly than its predecessors so far.
Possible treatments for coronavirus
Currently, treatment for the virus is difficult, and in severe cases, patients need to be put on ventilators to assist with breathing. Because the virus attacks the respiratory system, it inhibits the proper function of the lungs, and since there are no specific vaccines or medications that have been used in the successful treatment of SARS-CoV-2 to date, it’s been solely up to the patient’s immune system to fight it off. Other forms of treatment are used only in the battle against symptoms and include pain relievers, cough syrup and medications to help with the dry cough associated with the virus, and fluid intake.
Different health organisations have begun to develop medications that may have some efficacy in treating SARS-CoV-2 based on studies done in relation to both MERS and SARS, including remdesivir, which was shown to have an antiviral effect in animal models, and chloroquine, which has been effective in the treatment of malaria. There are also a number of vaccines in development across the world.
What is disulfiram?
As different treatments are explored in various countries, a study published in 2018 could shed a light on the medication disulfiram. Although this drug is usually used in the treatment of alcohol addiction, researchers discovered that it can also inhibit the enzyme protease, which could lead to a faster recovery from the virus.
Disulfiram is a synthetic compound medication that has been successfully used to inhibit the body’s ability to make acetaldehyde dehydrogenase. In the case of alcohol addiction, this inhibition leads the body to feel ill immediately after consuming alcohol, which helps patients overcome their need for it. In the case of SARS-CoV-2, it has been discovered that disulfiram can have antibacterial properties when used with a certain metabolite.
Is disulfiram effective at treating SARS-CoV-2?
Although no formal testing for the use of disulfiram against the current strain of coronavirus has been done, the medication does show promise for being a possible treatment based on its ability to affect the virus cells of both MERS and SARS. It was found that disulfiram has the ability to bind slowly to the virus cells, which in turn allows the enzyme inhibition to occur over a shorter span of time. This action can limit the virus cell’s ability to thrive in the body.
In the specific study done on the use of disulfiram for the treatment of MERS and SARS, it was also noted that its use alongside 6-thioguanine (a medication used in the treatment of different forms of leukaemia) and mycophenolic acid (a medication designed to suppress the overaction of the immune system in patients who have just undergone organ transplant surgery) could lead to a higher success rate in the inhibition of virus cell takeover. The study shows promise in future treatments of SARS-CoV-2 – however, the drugs were only used with the MERS and SARS version of the virus, thus more study needs to be done to confirm the efficacy of disulfiram for the current pandemic overtaking the world.
How to treat SARS-CoV-2 patients with disulfiram
To properly treat patients with disulfiram, more studies need to investigate how it works within the bodies of those suffering from the virus, the side effects that may occur, and how effective it is. Since there are currently no trials being completed surrounding disulfiram and the SARS-CoV-2 virus, no dosage recommendations can be expected.
In theory, treatment with disulfiram would need to be done under supervision of a doctor and taken in conjunction with other medications such as the ones mentioned above for it to have full efficacy against the virus. Since the study was published on SARS and MERS and the use of disulfiram showed promise against those coronaviruses, it is a possible treatment to explore further due to its ability to help inhibit the protease protein. The good news surrounding disulfiram is that it has been FDA-approved for 70 years, so advancing to human clinical trials in the fight against the SARS-CoV-2 virus should be able to go ahead without any serious roadblocks.