Intranasal Antiviral Drug Delivery and Coronavirus Disease 2019 (COVID‐19): A State of the Art Review

Abstract

Objective To provide a state of the art review of intranasal antiviral drug delivery and to discuss current applications, adverse reactions, and future considerations in the management of coronavirus disease 2019 (COVID-19). Data Sources PubMed, Embase, and Clinicaltrials.gov search engines. Review Methods A structured search of the current literature was performed of dates up to and including April 2020. Search terms were queried as related to topics of antiviral agents and intranasal applications. A series of video conferences was convened among experts in otolaryngology, infectious diseases, public health, pharmacology, and virology to review the literature and discuss relevant findings. Conclusions Intranasal drug delivery for antiviral agents has been studied for many years. Several agents have broad-spectrum antiviral activity, but they still require human safety and efficacy trials prior to implementation. Intranasal drug delivery has potential relevance for future clinical trials in the settings of disease spread prevention and treatment of SARS-CoV-2 and other viral diseases. Implications for Practice Intranasal drug delivery represents an important area of research for COVID-19 and other viral diseases. The consideration of any potential adverse reactions is paramount.

A potent bispecific nanobody protects hACE2 mice against SARS-CoV-2 infection via intranasal administration

“…5). SARS-CoV-2 is mainly present in the nasopharynx and lungs 31,32 . Differing from many previously reported systemic delivery route, Nb 15 -Nb H -Nb 15 was delivered to the site of infection.…”

“…Differing from many previously reported systemic delivery route, Nb 15 -Nb H -Nb 15 was delivered to the site of infection. Direct administration to the airways is likely to provide faster and more robust antiviral activity in the respiratory tract, where the virus gains entry and replicate 16,32 , as intranasal delivery has been shown to result in fast and efficient drug delivery to the main site of SARS-CoV-2 infection, i.e., the upper and lower respiratory tract 32 . Indeed, the therapeutic effect of topical administration of ALX-0171 displayed promising results in reducing the RSV viral load 14,16 .…”

Magnetic particle targeting for diagnosis and therapy of lung cancers

“…This strategy can lead to a more efficient treatment and clinical prognosis. Also, computational fluid dynamics could be utilized to determine appropriate particle size, location of magnet, spray velocity, and dosing, for effective therapies for pulmonary viral infectious diseases like COVID-19 [ 241 ].…”

Understanding Severe Acute Respiratory Syndrome Coronavirus 2 Replication to Design Efficient Drug Combination Therapies

“…Drug combination might help to reduce the dose or the time of application of this mixed therapy. Nasal administration is also a promising alternative that might overcome both toxicity effects and effective concentration challenges [63].…”