Abstract
The coronavirus disease 2019 (COVID-19) represents a global concern of public health caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Its clinical manifestations are characterized by a heterogeneous group of symptoms and pictures (ranging from asymptomatic to lethal courses). The prevalence of conjunctivitis in patients with COVID-19 is at present controversial. Although it has been reported that only 0.9% developed signs of conjunctivitis, other report indicates that up to 31.6% of hospitalized patients had conjunctivitis. Considering the widespread use of topical ophthalmic medications (e.g., eye drops) by the general population, for various reasons (e.g., artificial tears, anti-glaucoma medications, topical antibiotics, etc.), the existence of their side effects as antiviral action should be investigated in-depth because it could possibly explain the aforementioned controversial data and represent a potential antiviral treatment for SARS-CoV-2 replication/diffusion on the ocular surface. Here, we discuss and elucidate the antiviral side effect of many eye drops and ophthalmic ointments commonly used for others purposes, thus showing that these secondary effects (not to be confused with the ‘adverse effects’) might be of primary importance in a number of viral infections (e.g., those for which there is no validated treatment protocol), according to a drug repurposing approach. Some active ingredients or excipients described here have activity against other types of viruses, thus suggesting potential broad-spectrum applications.
Highlights
The coronavirus disease 2019 (COVID-19) represents a global concern of public health that quickly spread around the world in early 2020 [1,2]
The detection of specific cell-surface receptors on the ocular surface, called angiotensin converting enzyme 2 (ACE2), and proteins promoting the binding between the virus and the host cell, named transmembrane protease serine 2 (TMPRSS2), is of considerable importance for understanding the presence of SARS-CoV-2 at eye level [3]
We summarize different classes of drugs with antiviral activity that have a repurposing potential (Table 3)
Summary
The coronavirus disease 2019 (COVID-19) represents a global concern of public health that quickly spread around the world in early 2020 [1,2]. Apart from the problem of interpersonal transmission of COVID-19 through conjunctiva and the relative issues on the presence and replication of the virus at the level of human tears and ocular surface epithelia, the appearance of conjunctivitis in COVID-19 may be presumed to be not uncommon on the basis of inherent ocular tropism of other viral upper respiratory tract infections (adenovirus being the most common). Considering the widespread use of topical ophthalmic medications by the general population for various reasons (e.g., artificial tears, anti-glaucoma medications, topical antibiotics, etc.), the existence of side effects as an antiviral action should be investigated in-depth because it could possibly explain the aforementioned controversial data and represent a potential antiviral treatment for SARS-CoV-2 replication/diffusion on the ocular surface. We discuss and elucidate the antiviral side effect of many eye drops and ophthalmic ointments commonly used for others purposes, showing that these secondary effects (not to be confused with the “adverse effects”) might be of primary importance in a number of viral infections (in particular, those for which there is no validated treatment protocol), according to a drug repurposing approach
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