Acyclovir As a Potential Add-On Treatment for COVID-19; A Narrative Review

Authors:
Preprint
Publisher website
Google Scholar
Abstract
Introduction: There are successful reports of concomitant management of herpes infection and coronavirus disease 2019 (COVID-19), using both the COVID-19 treatment regimen and acyclovir. In addition, acyclovir has been proposed to be effective in treating COVID-19 through various mechanisms, such as inhibition of the viral protease enzyme, expressions of multiple other viral genes, and RNA-dependent RNA polymerase. Therefore, in this narrative review, we aimed to review the reported cases of patients with concomitant COVID-19 and herpes infection who received concurrent antiviral therapy for herpetic lesions. Methods: We conducted a search for relevant articles published between December 2019 and December 2020, without language limitations, using the PubMed database with MeSH (Medical Subject Heading) terms related to herpes simplex virus or herpes zoster combined with COVID-19. We included reports of concomitant COVID-19 and herpes infection who received concurrent antiviral therapy for herpetic lesions. Results: Among the 90 articles, 11 reporting concurrent laboratory-confirmed COVID-19 and herpes infection, with prescribed antiviral therapy for herpetic infection, were included. There were 28 patients (age range, 7–82 years) with laboratory-confirmed COVID-19, detected using reverse transcription-polymerase chain reaction, concomitant with reactivation of herpes infection who received concurrent antiviral therapy (besides routine COVID-19 management); no mortality was reported. Mean (SD [range]) age of these 28 patients at treatment was 56.4 (18.6 [7–82]) years, and the majority were male (n = 18, 64.3%). Twenty patients received acyclovir, and eighth received other two antiviral compounds including seven cases valacyclovir, and one case famciclovir, with no mortality was reported. Conclusion: Acyclovir could be considered as a potential add-on treatment besides the COVID-19 treatment regimen. However, further clinical trials to test this hypothetical adjuvant therapy are recommended.

This publication has 30 references indexed in Scilit: