Adamantanes for the Prevention of COVID-19: A Review of Case Reports

Clinical evidence is reviewed for the possible use of the adamantanes amantadine and memantine, for the prevention and/or treatment of COVID-19. Literature searches revealed three series of case reports authored by independent teams of international investigators. Subjects were comprised principally of patients receiving amantadine or memantine for several weeks as part of their treatment regimen for Parkinson’s disease, Multiple Sclerosis or Cognitive impairment prior to their infection by SARS-CoV-2. All patients tested positive for SARSCoV-2 confirmed by RT-PCR of nasopharyngeal swabs. Interestingly, the majority of cases manifested age-related vulnerabilities to COVID-19 as well as the presence of co-morbidities resulting from either severe neurological disorders or type-2 diabetes. Amantadine appeared to prevent the appearance of typical COVID-19related clinical manifestations of infectious disease in 23/24 cases. In addition, one patient with type-2 diabetes treated with amantadine for 14 days showed clear improvements in clinical status and in oxygen saturation levels; by day 6 he could breathe without the need for oxygen supplementation and was discharged from hospital on day 14. It is necessary to now confirm these findings by randomized controlled trials in order to objectively evaluate the use of these agents for the prevention and/or treatment of COVID-19.