The use of amantadine in the prevention of progression and treatment of COVID-19 symptoms in patients infected with the SARS-CoV-2 virus (COV-PREVENT): Study rationale and design

Konrad Rejdak, Piotr Fiedor, Robert Bonek, Aleksander Goch, Agnieszka Gala-Błądzińska, Waldemar Chełstowski, Jacek Łukasiak, Sławomir Kiciak, Piotr Dąbrowski, Mateusz Dec, Zbigniew J Król, Ewa Papuć, Adriana Zasybska, Agnieszka Segiet, Paweł Grieb, Konrad Rejdak, Piotr Fiedor, Robert Bonek, Aleksander Goch, Agnieszka Gala-Błądzińska, Waldemar Chełstowski, Jacek Łukasiak, Sławomir Kiciak, Piotr Dąbrowski, Mateusz Dec, Zbigniew J Król, Ewa Papuć, Adriana Zasybska, Agnieszka Segiet, Paweł Grieb

Abstract

Background: COVID-19, a disease caused by infection with the SARS-CoV-2 virus, is asymptomatic or mildly symptomatic in most cases. Some patients, usually burdened with risk factors develop acute respiratory failure and other organ dysfunction. In such cases, the mortality rate is very high despite the use of intensive therapy. Amantadine has complex activity including antiviral, antiinflammatory and dopaminergic effects. This clinical trial will assess the efficacy and safety of amantadine in the prevention of COVID-19 progression toward acute respiratory failure and neurological complications.

Methods and results: The trial will enroll 200 patients who are positive for SARS-CoV-2 infection and have one or more risk factors for worsening the disease. These patients will be included as hospitalized or ambulatory subjects for early treatment of illness. The recruitment will take place in 8 centers covering different regions of Poland. For 14 days they will be given either 200 mg of amantadine a day or placebo. Our hypothesis is a considerable reduction in the number of patients with progression toward respiratory insufficiency or neurological complications thanks to the treatment of amantadine.

Conclusions: Demonstrating the efficacy and safety of amantadine treatment in improving the clinical condition of patients diagnosed with COVID-19 is of great importance in combating the effects of the pandemic. It has potential to influence on the severity and course of neurological complications, which are very common and persist long after the infection as long-COVID syndrome.

Clinical trial registration: www.

Clinicaltrials: gov identification no. NCT04854759; Eudra CT number: 2021-001144-98 (dated 27 February 2021).

Keywords: Amantadine; COVID-19; Neurological complications; Outcome; Protocol; Trial.

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper

Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.

Figures

Fig. 1.
Fig. 1.
Possible mechanisms of amantadine activity in the early phase of COVID-19.

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