A global team of scientists led by Dr Sumit Chanda, a professor at Sanford Burnham Prebys Medical Discovery Institute, in a Nature study has identified 21 existing drugs that stop the replication of SARS-CoV-2, the virus that causes COVID-19.
The scientists analyzed one of the world’s largest collections of known drugs for their ability to block the replication of SARS-CoV-2 and reported 100 molecules with confirmed antiviral activity in laboratory tests.
This is coming as an Israeli company is developing a coronavirus breathalyser test that gives results in 30 seconds, billing it as a “front line” tool that can help restore a sense of normality during the pandemic.
NanoScent, the firm making the test kits, says an extensive trial in Israel for the presence of live virus delivered results with 85 percent accuracy, and the product could receive regulatory approval within months.
Its Chief Executive Officer, Oren Gavriely, told AFP the breathalyser will not replace lab tests but was a mass screening tool that could help people gain “the confidence to go back and act as normal”.
NanoScent has been operating for several years, specialising in rapid recognition technology, including for medical purposes.
Gavriely said that while visiting the United States in January, he sensed his firm’s expertise may be needed to help confront the novel virus circulating in Asia that appeared to be spreading to the West.
“We said we’ll invest one week into it and see what’s happening, and this one week never stopped”, he said.
The test begins with a few short questions about COVID-19 exposure and symptoms, displayed on the phone of the person administering the procedure.
Test subjects then inhale through the nose, hold their breath, close one nostril and exhale through the other, pushing breath through a handheld tube into a small bag called the “Air Trap”.
The tube is then plugged into the “Scent Reader”, a small rectangular device that whirrs softly as it sucks the air out of the bag.
Within seconds the results—”COVID-19 negative” during AFP’s visit—appear on the phone.
Researchers at NanoScent’s headquarters in northern Israel are refining the virus recognition technology, which relies on “odours and the pattern of odours”, Gavriely said.
After analysing the breath of roughly 1,000 Israeli COVID-19 patients, the firm was able to identify detectable smells associated with the virus, the chief executive added.
“We pick up on a pattern, we record that pattern and then we can detect if someone has, or is suspected to have, COVID-19.”
NanoScent’s technology was looking “very promising,” said Nadav Davidovitch, director of the school of public health at the Ben Gurion University in Beersheba.
Mass testing is crucial during a pandemic, he told AFP, adding that the NanoScent test could be a useful tool, provided it gets regulatory approval.
As long as NanoScent’s breathalyser was not used by some as a substitute for state-controlled lab tests, “I’m all for it”, he said.
Gavriely told AFP he expected the test to be used at entrances to concerts and hospitals, or in the aviation industry—noting it was already being used at a major European sports venue, in a commercial pilot.
If the breathalyser result is positive, people should automatically be sent for a lab test, he said.
The device will likely cost less than $10 per test, “a fraction of the cost of the lab test”, Gavriely said.
The Israeli Defence Ministry’s Research and Development Directorate worked to help NanoScent develop its testing system, with department head Daniel Gold recently telling AFP that rapid testing would be a “game-changer” against the pandemic.
Israel acted early against the virus in March and succeeded in reducing transmission to a trickle by early May, but as the economy has re-opened cases have spiked dramatically.
The country of nine million people has been recording more than 1,000 new cases per day in recent weeks, forcing new restrictions and public anger over the purportedly mismanaged re-opening.
Gavriely voiced hope that rapid, mass screening could help Israel strike a balance between essential restrictions and normal life.
Scent recognition platforms are “a quick way to screen the masses and know who’s suspected, who’s not, so we can be confident again,” he said.
In the meantime, Nigeria on Saturday recorded 438 new confirmed COVID-19 cases and 11 deaths.
According to the Nigeria Centre for Disease Control (NCDC), ‘’till date, 39977 cases have been confirmed, 16948 cases have been discharged and 856 deaths have been recorded in 36 states and the Federal Capital Territory, Abuja.’’
Of the 438 new cases from 24 states, Lagos logged 123 cases, Kaduna 50, Rivers 40, Edo 37, Adamawa 25, Oyo 20, Nasarawa 16, Osun 15, Enugu 15, Abuja 14, Ekiti 13, Ondo 13, Ebonyi 11, Katsina 10, Abia nine, Delta eight, Kwara four, Ogun three, Cross River three, Kano three, Bauchi three, Yobe two, Sokoto and Niger one each.
However, the 21 drugs were determined to be effective at concentrations that could be safely achieved in patients. Notably, four of these compounds were found to work synergistically with remdesivir, a current standard-of-care treatment for COVID-19.
“Remdesivir has proven successful at shortening the recovery time for patients in the hospital, but the drug doesn’t work for everyone who receives it. That’s not good enough”, says Chanda, Director of the Immunity and Pathogenesis Programme at Sanford Burnham Prebys and senior author of the study.
“As infection rates continue to rise in America and around the world, the urgency remains to find affordable, effective, and readily available drugs that can complement the use of remdesivir, as well as drugs that could be given prophylactically or at the first sign of infection on an outpatient basis.”
Extensive testing conducted
In the study, the research team performed extensive testing and validation studies, including evaluating the drugs on human lung biopsies that were infected with the virus, evaluating the drugs for synergies with remdesivir, and establishing dose-response relationships between the drugs and antiviral activity.
Of the 21 drugs that were effective at blocking viral replication, the scientists found:
13 have previously entered clinical trials for other indications and are effective at concentrations, or doses, that could potentially be safely achieved in COVID-19 patients.
Two are already FDA approved: astemizole (allergies), clofazamine (leprosy), and remdesivir has received Emergency Use Authorization from the agency (COVID-19).
Four worked synergistically with remdesivir, including the chloroquine derivative hanfangchin A (tetrandrine), an antimalarial drug that has reached Phase 3 clinical trials.
“This study significantly expands the possible therapeutic options for COVID-19 patients, especially since many of the molecules already have clinical safety data in humans”, says Chanda. “This report provides the scientific community with a larger arsenal of potential weapons that may help bring the ongoing global pandemic to heel.”
The researchers are currently testing all 21 compounds in small animal models and “mini lungs,” or lung organoids, that mimic human tissue. If these studies are favorable, the team will approach the U.S. Food and Drug Administration (FDA) to discuss a clinical trial(s) evaluating the drugs as treatments for COVID-19.
“Based on our current analysis, clofazimine, hanfangchin A, apilimod and ONO 5334 represent the best near-term options for effective COVID-19 treatment”, says Chanda. “While some of these drugs are currently in clinical trials for COVID-19, we believe it’s important to pursue additional drug candidates so we have multiple therapeutic options if SARS-CoV-2 becomes drug-resistant.”
The drugs were first identified by high-throughput screening of more than 12,000 drugs from the ReFRAME drug repurposing collection—the most comprehensive drug repurposing collection of compounds that have been approved by the FDA for other diseases or that have been tested extensively for human safety.
Vice President of Medicinal Chemistry at Calibr and co-author on the paper, Arnab Chatterjee, Ph.D., says ReFRAME was established to tackle areas of urgent unmet medical need, especially neglected tropical diseases.
“We realised early in the COVID-19 pandemic that ReFRAME would be an invaluable resource for screening for drugs to repurpose against the novel coronavirus”, says Chatterjee.
The drug screen was completed as rapidly as possible due to Chanda’s partnership with the scientist who discovered the first SARS virus, Kwok-Yung Yuen, M.D., chair of Infectious Diseases at the University of Hong Kong; and Shuofeng Yuan, Ph.D., assistant research professor in the Department of Microbiology at the University of Hong Kong, who had access to the SARS-CoV-2 virus in February 2020.