Since its licensing in 1971, the synthetic compound inosine pranobex has been effectively combating viral infections, including herpes zoster, varicella, measles, and infections caused by the herpes simplex virus, human papillomavirus, Epstein-Barr virus, cytomegalovirus, and respiratory viruses. With the emergence of SARS-CoV-2, new and existing drugs have been intensively evaluated for their potential as COVID-19 medication. Due to its potent immunomodulatory properties, inosine pranobex, an orally administered drug with pleiotropic effects, can, during early treatment, alter the course of the disease. We describe the action of inosine pranobex in the body and give an overview of existing evidence collected to support further efforts to study this drug in a rigorous clinical trial setup.

• Keywords
• COVID-19, SARS-CoV-2, drug repurposing, immunomodulation, inosine pranobex, isoprinosine, lymphopenia, methisoprinol,
• MeSH
• Antiviral Agents therapeutic use   MeSH
• Killer Cells, Natural immunology   MeSH
• COVID-19 complications   immunology   MeSH
• T-Lymphocytes, Cytotoxic immunology   MeSH
• COVID-19 Drug Treatment * MeSH
• Immunomodulating Agents pharmacology   therapeutic use   MeSH
• Inosine Pranobex pharmacology   therapeutic use   MeSH
• Clinical Trials as Topic MeSH
• Humans MeSH
• Lymphopenia MeSH
• Drug Repositioning MeSH
• Immunity, Innate MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Review MeSH
• Names of Substances
• Antiviral Agents MeSH
• Immunomodulating Agents MeSH
• Inosine Pranobex MeSH

During the COVID-19 pandemic, the elderly population has been disproportionately affected, especially those in nursing homes (NH). Inosine pranobex (IP) has been previously demonstrated to be effective in treating acute viral respiratory infections. In three NH experiencing the SARS-CoV-2 virus epidemic, we started treatment with IP as soon as clients tested PCR+. In Litovel, CZ, the difference in case-fatality rate (CFR) for the PCR+ group using vs. not using IP was statistically significant, and the odds ratio (OR) was 7.2. When comparing all those taking IP in the three NH vs. the non-drug PCR+ group in Litovel, the odds ratio was lower for all three NH, but still significant at 2.9. The CFR in all three tested NHs, age range 75-84, compared to the CFR in all NHs in the Czech Republic, was significantly reduced (7.5% vs. 18%) (OR: 2.8); there was also a significant difference across all age groups (OR: 1.7). In our study with 301 residents, the CFR was significantly reduced (OR: 2.8) to 11.9% (17/142) in comparison to a study in Ireland with 27.6% (211/764). We think the effect of IP was significant in this reduction; nevertheless, these are preliminary results that need larger-scale trials on COVID-19 patients.

• Keywords
• COVID-19, acute respiratory viral infection, case-fatality rate, inosine pranobex, natural killer cells, nursing homes, treatment,
• Publication type
• Journal Article MeSH