Montelukast as a potential treatment for COVID-19

ABSTRACT

Introduction

Montelukast is a leukotriene inhibitor that is widely used to treat chronic asthma and allergic rhinitis. The drug interferes with molecular signaling pathways produced by leukotrienes in a variety of cells and tissues throughout the human body that lead to tightening of airway muscles, production of aberrant pulmonary fluid (airway edema), and in some cases, pulmonary inflammation.

Areas Covered

Montelukast has also been noted to have anti-inflammatory properties, suggesting it may have a role in the treatment of coronavirus disease 2019 (COVID-19), the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has been noted to induce misfiring of the immune system in some patients. A literature search of PubMed was performed to identify all relevant studies of montelukast and SARS-CoV-2 through 27 January 2023.

Expert Opinion

Montelukast has been the subject of small studies of SARS-CoV-2 and will be included in a large, randomized, double-blind, placebo-controlled study of outpatients with COVID-19 sponsored by the United States National Institutes of Health known as Accelerating COVID-19 Therapeutic Interventions and Vaccines-6. This paper reviews what is known about montelukast, an inexpensive, well-tolerated, and widely available medication, and examines the rationale for using this drug to potentially treat patients with COVID-19.

KEYWORDS:

• Montelukast
• SARS-CoV-2
• COVID-19
• allergic rhinitis
• asthma

Article highlights

• Montelukast sodium is a cysteinyl leukotriene receptor antagonist that is used to treat chronic asthma and allergic rhinitis.

• Leukotrienes are involved in a variety of immunologic responses against microorganisms.

• Overproduction or inappropriate signaling by leukotrienes may lead to inflammatory diseases, such as pulmonary fibrosis, cardiovascular disease, and oxidative stress throughout the human body.

• Severe COVID-19 has been characterized by aberrant signaling of the human immune system.

• Some evidence suggests that montelukast may serve as a therapeutic option for the treatment of COVID-19.

Declaration of interest

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.