Currently, remdesivir is the only Food and Drug Administration approved antiviral for COVID-19. Recent reports of viral mutations in the novel coronavirus are leading to a more infectious agent than at the beginning of the pandemic. Presented in this article are cases that were treated with an old drug, acyclovir.
To date, 38 patients have received treatment with acyclovir. The following 4 cases highlight the benefits of acyclovir. Acyclovir has proven to be effective, safe and inexpensive in 29 patients. 9 patients are still under treatment. No adverse effects or death have been observed with this treatment thus far. Further studies comparing acyclovir to remdesivir are needed to validate benefits from acyclovir for SARS-CoV-2 infection.
The National Institutes of Health recommended remdesivir as the only FDA-approved drug for COVID-19 treatment thus far. However, it has also mentioned that treatment plans, including the use of remdesivir, should not be mandated, and the choice to use it rests with the patient and provider [5]. While guidelines promote remdesivir, the drug has come with mixed outcomes and a high cost. The drug lacks a “demonstrated survival benefit,” and so new developments must be made
Since July 2020, our clinic has used acyclovir as a primary antiviral for COVID-19 treatment. Acyclovir is a nucleoside analogue used to treat herpes virus infections, which is selective to the herpes simplex enzyme thymidine kinase. The drug inhibits viral DNA polymerase through phosphorylation of the acyclovir compound [10]. Acyclovir has been an inexpensive, safe, and well tolerated alternative to treating mild-tosevere cases of COVID-19 for our hospitalized and non-hospitalized patients. The following cases lend support to this statement.
Acyclovir and Azithromicyn together