Potential antiviral and anti-inflammatory role of Montelukast in viral infections including SARS-CoV-2 Infection (COVID19) – A Descriptive review

Abstract

The rapidly progressing Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is much more transmissible than it's close genetic relative of other beta coronaviruses severe acute respiratory syndrome (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV). In humans, the Cysteinyl leukotrienes are found to be elevated in the viral induced wheezing pathway, with expression of cysteinyl leukotriene receptor subtype 1 (CysLTR1) on the airway smooth muscle cells, nasal mucous glands, epithelial cells, respiratory tract macrophages, and on other inflammatory cells like eosinophils, some macrophages, mast cells, neutrophils, and certain myeloid stem cells. Montelukast, a leukotriene receptor antagonist, which has known effect in treating wheezing induced by several viral infections associated with elevations of leukotrienes in the nasal secretions like influenza A, RSV, zika virus and rhinovirus has capacity to disrupt the integrity of the virions and curbing viral replication. The silico modeling of Montelukast's binding to the SARS-Cov-2 viral protein curbing the release of viral genomic RNA warrants further investigation for antiviral benefits of Montelukast in COVID-19.