Abstract
The potentially lethal COVID-19 infection caused by the novel Severe
Acute Respiratory Disease Coronavirus-2 (SARS-CoV-2) has evolved into a
global crisis. There are two major processes that lead to the morbidity
and mortality of this disease: initially the viral infection, followed
by a host inflammatory response that frequently results in excessive
secretion of inflammatory cytokines (e.g. IL-6, IL-8, IL-10, TNFα),
developing into a self-targeting toxic “cytokine storm” in which the
lungs fill with inflammatory secretions causing critical pulmonary
tissue damage. Even though the search for a vaccine and anti-viral
agents has already been initiated, the de novo development of a safe,
COVID-19 specific solution may take years; regrettably, the need for a
therapeutic that is available immediately is growing daily. Therefore,
repurposing an already approved drug offers a promising approach to
address this urgent need. A truly effective therapeutic, however, should
be available not only for the single individual in a developed country,
but also for the many people in developing countries. As presented in
this review, inhaled furosemide, a small molecule capable of inhibiting
IL-6, IL-8 and TNFα within the lung, may be an agent capable of treating
the COVID-19 cytokine storm in both resource-rich and developing
countries. Furosemide is a “repurpose-able” small molecule
therapeutic, that is safe, easily synthesized, handled and stored, and
is available in reasonable quantities worldwide.