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Rapid response to:


Response to the emerging novel coronavirus outbreak

BMJ 2020; 368 doi: (Published 31 January 2020) Cite this as: BMJ 2020;368:m406

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Rapid Response:

Re: Response to the emerging novel coronavirus outbreak

Dear Editor

With the ongoing spread of COVID-19 virus all around the world and with knowing this concept that not all potential suggested-for-trials drugs against this virus are available in countries like Iran, a rather available and the over-the-counter drug, Naproxen as a promising treatment or prevention agent may be suggested besides the supportive management.

COVID-19 virus is an enveloped, positive-sense, single-stranded RNA beta-coronavirus [1]. Naproxen, a non-steroidal anti-inflammatory drug, has previously been revealed to exert antiviral activity against influenza A virus by impeding nucleoprotein (NP) binding to RNA in a study by Nathalie Lejal et al [2]. Furthermore, Weinan Zheng et al [3] indicated that naproxen is a potential broad, multi-mechanistic anti-influenza virus therapeutic, as it inhibits influenza B virus replication both in vivo and in vitro. Additionally, the NP of influenza B virus (BNP) has a higher binding affinity to naproxen than influenza A virus NP (ANP). Specifically, naproxen targets the NP at residues F209 (BNP) and Y148 (ANP). This interaction antagonizes the nuclear export of NP normally mediated by the host export protein CRM1.

Based on the fact that the COVID-19 virus is single-stranded RNA virus and Naproxen has an antiviral activity via inhibiting nucleoprotein (NP) binding to RNA in the replication process of RNA-viruses like influenza A/B, the use of Naproxen as a probable agent for control of widespread novel coronavirus infection may be assumed.

Published literature relating to the effect of Naproxen on the COVID-19 virus is limited. Clinicians may consider the use of Naproxen for treatment of the infected host cell and spread of infection besides using its anti-inflammatory feature in patients with more severe symptoms. Clinical trials and research may reveal this efficiency.

1. Zumla, A., Chan, J., Azhar, E. et al. Coronaviruses — drug discovery and therapeutic options. Nat Rev Drug Discov 15, 327–347 (2016).
2. Lejal, N., Tarus, B., Bouguyon, E., et al. Structure-based discovery of the novel antiviral properties of naproxen against the nucleoprotein of influenza A virus. Antimicrob Agents Chemother 57, 2231–2242 (2013).
3. Zheng, W., Wenhui, F., Shuang, Z. al. Naproxen exhibits broad anti-influenza virus activity in mice by impeding viral nucleoprotein nuclear export. Cell reports 27, 1875-1885 (2019).

Competing interests: No competing interests

25 February 2020
Farzan Safi Dahaj
Medical student
Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Shahid Sadoughi Hospital, Ebnecina BLV. Safaeyeh, Yazd, Iran