US20210220353A1 - Use of favipiravir in treatment of coronavirus infection - Google Patents

Use of favipiravir in treatment of coronavirus infection Download PDF

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US20210220353A1
US20210220353A1 US17/070,620 US202017070620A US2021220353A1 US 20210220353 A1 US20210220353 A1 US 20210220353A1 US 202017070620 A US202017070620 A US 202017070620A US 2021220353 A1 US2021220353 A1 US 2021220353A1
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coronavirus
sars
cov
disease
disease caused
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Wu Zhong
Ruiyuan CAO
Cheng Cao
Ting Gao
Gengfu XIAO
Zhihong Hu
Manli Wang
Leike ZHANG
Song Li
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Academy of Military Medical Sciences AMMS of PLA
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Assigned to ACADEMY OF MILITARY MEDICAL SCIENCES reassignment ACADEMY OF MILITARY MEDICAL SCIENCES ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: CAO, CHENG, CAO, Ruiyuan, GAO, TING, HU, Zhihong, LI, SONG, WANG, MANLI, XIAO, GENGFU, ZHANG, Leike, ZHONG, WU
Priority to US17/378,361 priority Critical patent/US11318135B2/en
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
    • A61K31/4965—Non-condensed pyrazines
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P11/00—Drugs for disorders of the respiratory system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
    • A61P31/12—Antivirals
    • A61P31/14—Antivirals for RNA viruses

Definitions

  • the present application relates to use of Favipiravir represented by the following Formula I, a geometric isomer, a pharmaceutically acceptable salt, a solvate, and/or a hydrate thereof, and a pharmaceutical composition comprising the above compound, in treating an infection caused by a coronavirus, especially SARS coronavirus (SARS-CoV) and SARS-CoV-2.
  • SARS-CoV SARS coronavirus
  • SARS-CoV-2 SARS coronavirus
  • Favipiravir (compound represented by Formula I, T-705) with chemical name of 6-fluoro-3-hydroxypyrazine-2-carboxamide, which is a nucleoside analogue drug, is a viral RNA polymerase inhibitor.
  • This drug is a broad-spectrum antiviral drug that has been approved as an anti-influenza drug in Japan.
  • Favipiravir has good inhibitory effects in vitro and in vivo on members of virulent RNA virus families such as Filoviridae, Bunyaviridae, Arenaviridae, Togaviridae, as well as members of other virus families such as Orthomyxoviridae, Paramyxoviridae, Picornaviridae, Flaviviridae, but its activity against coronavirus has not been reported.
  • Favipiravir After entering a cell, Favipiravir can be converted into an active form of triphosphate, which is incorporated into the RNA chain during the transcription and replication of RNA virus, and non-specifically terminates the extension of the viral RNA chain, thereby achieves antiviral effects.
  • Favipiravir can effectively inhibit the virus titer in the supernatant after Vero E6 cell line was infected by viruses, and has a half-inhibitory concentration (IC 50 ) of 67 ⁇ mol/L to EBOV-Zaire type.
  • Favipiravir was not cytotoxic to Vero C1008 cells at a high concentration of 1.95 g/L, and could completely inhibit the cytopathic effect (CPE) of EBOV-Zaire type to cells at the drug concentration of above 62.5 mg/L.
  • CPE cytopathic effect
  • the A129 mouse models with both type I and type II interferon deficiencies were challenged at a dose of 100% death of the placebo group, and immediately intragastrically administered Favipiravir at dose of 300 mg/kg/d (2 times/d, 150 mg/kg per time) 1 h after the challenge for consecutive 14 days, which could protect 100% of the mice from death, and the body weight of the mice in the administration group had been significantly improved.
  • 2019 novel Coronavirus 2019-nCoV
  • ICTV International Committee on Taxonomy Viruses
  • SARS-CoV-2 severe acute respiratory syndrome coronavirus 2
  • WHO World Health Organization
  • SARS-CoV-2 virus infection are mainly pneumonia, and can be divided into simple infection, mild pneumonia, severe pneumonia, acute respiratory distress syndrome, sepsis, septic shock and so on according to the severity of disease.
  • Patients with simple infection may have non-specific symptoms, such as fever, cough, sore throat, nasal congestion, fatigue, headache, muscle pain or discomfort, and the elderly people and immunosuppressed people may have atypical symptoms.
  • Patients with mild pneumonia mainly have cough, dyspnea and polypnea. Severe pneumonia can be seen in adolescents, adults or children, and the main symptoms of which include increased breathing frequency, severe respiratory failure or dyspnea, central cyanosis, drowsiness, unconsciousness or convulsion, gasp, etc.
  • the lung images of acute respiratory distress syndrome are bilateral ground glass shadows, which cannot be completely explained by effusion, lobar exudation or atelectasis or lung mass shadows, and the main symptom of which is pulmonary edema. Patients with sepsis often have fatal organ dysfunction, and the most critical patients are those with septic shock, and they may have a high probability of death.
  • the novel coronavirus infection is mainly treated with supportive therapy in clinic, and no specific antiviral drug is available.
  • the purpose of the present application is to find a drug with antiviral activity against coronavirus, especially SARS coronavirus (SARS-CoV) and SARS-CoV-2, which can be used for the treatment of a related disease caused by the infection thereof, such as simple infection (such as fever, cough and sore throat), pneumonia, acute or severe acute respiratory tract infection, hypoxic respiratory failure and acute respiratory distress syndrome, sepsis and septic shock.
  • SARS-CoV SARS coronavirus
  • SARS-CoV-2 SARS coronavirus-2
  • Favipiravir represented by Formula I has the function of inhibiting the replication of SARS coronavirus (SARS-CoV) and SARS-CoV-2, and has a good potential therapeutic effect in the treatment of a disease caused by SARS coronavirus (SARS-CoV) or SARS-CoV-2.
  • the present application relates to a compound represented by Formula I, a geometric isomer, a pharmaceutically acceptable salt, a solvate and/or a hydrate thereof:
  • the pharmaceutically acceptable salts of the compound represented by Formula I described herein include inorganic or organic acid salts and inorganic or organic base salts thereof.
  • the present application relates to all forms of the above salts, including but not limited to: sodium salt, potassium salt, calcium salt, lithium salt, meglumine salt, hydrochloride salt, hydrobromide salt, hydroiodide salt, nitrate salt, sulfate, hydrogen sulfate, phosphate, hydrogen phosphate, acetate, propionate, butyrate, oxalate, pivalate, adipate, alginate, lactate, citrate, tartrate, succinate, maleate, fumarate, picrate, aspartate, gluconate, benzoate, methanesulfonate, ethanesulfonate, benzenesulfonate, p-toluenesulfonate and embonate and so on.
  • the compound represented by Formula I can inhibit the replication of coronavirus in cells and reduce the nucleic acid load of coronavirus in cell culture.
  • the compound represented by Formula I can reduce the viral nucleic acid load in cells infected by SARS-CoV-2 at micromolar concentration level;
  • the compound represented by Formula I has a significant protective effect on the mice infected by SARS coronavirus (SARS-CoV).
  • the present application also relates to use of the compound represented by Formula I, a geometric isomer, a pharmaceutically acceptable salt, a solvate and/or a hydrate thereof in manufacture of a medicament for treating a disease or an infection (including but not limited to respiratory diseases (e.g., simple infections (such as fever, cough and sore throat), pneumonia, acute respiratory infection, severe acute respiratory infection (SARI), hypoxic respiratory failure and acute respiratory distress syndrome, sepsis and septic shock, severe acute respiratory syndrome (SARS), etc.)) caused by a coronavirus, especially a SARS coronavirus (SARS-CoV) and/or a SARS-CoV-2,
  • respiratory diseases e.g., simple infections (such as fever, cough and sore throat), pneumonia, acute respiratory infection, severe acute respiratory infection (SARI), hypoxic respiratory failure and acute respiratory distress syndrome, sepsis and septic shock, severe acute respiratory syndrome (SARS), etc.
  • a coronavirus especially a SARS coronavirus (
  • the present application also relates to use of the compound represented by Formula I, a geometric isomer, a pharmaceutically acceptable salt, a solvate and/or a hydrate thereof in manufacture of a medicament as coronavirus inhibitor.
  • the present application also relates to use of the compound represented by Formula I, a geometric isomer, a pharmaceutically acceptable salt, a solvate and/or a hydrate thereof in manufacture of a medicament for inhibiting the replication or reproduction of coronavirus in a cell (e.g., a cell of mammal).
  • the present application also relates to a pharmaceutical composition, which comprises the compound represented by Formula I, a geometric isomer, a pharmaceutically acceptable salt, a solvate and/or a hydrate thereof,
  • the pharmaceutical composition further comprises a pharmaceutically acceptable carrier or excipient.
  • the pharmaceutical composition is a solid preparation, an injection, an external preparation, a spray, a liquid preparation, or a compound preparation.
  • the pharmaceutical composition comprises an effective amount of the compound represented by formula I, a geometric isomer, a pharmaceutically acceptable salt, a solvate and/or a hydrate thereof.
  • the present application also relates to use of the pharmaceutical composition comprising the compound represented by Formula I, a geometric isomer, a pharmaceutically acceptable salt, a solvate and/or a hydrate thereof or the compound represented by Formula I, a geometric isomer, a pharmaceutically acceptable salt, a solvate and/or a hydrate thereof in manufacture of a medicament for treating a respiratory system disease, including but not limited to simple infection (such as fever, cough and sore throat), pneumonia, acute respiratory infection, severe acute respiratory infection (SARI), hypoxic respiratory failure, acute respiratory distress syndrome, sepsis, septic shock, severe acute respiratory syndrome (SARS), etc.).
  • simple infection such as fever, cough and sore throat
  • SARI severe acute respiratory infection
  • hypoxic respiratory failure acute respiratory distress syndrome
  • sepsis sepsis
  • septic shock severe acute respiratory syndrome
  • the present application also relates to a method for treating and/or preventing a disease in a mammal in need or a method for inhibiting the replication or reproduction of coronavirus in a mammal in need, the method comprises administering to the mammal in need a therapeutically and/or prophylactically effective amount of the pharmaceutical composition comprising the compound represented by Formula I, a geometric isomer, a pharmaceutically acceptable salt, a solvate and/or a hydrate thereof or the compound represented by Formula I, a geometric isomer, a pharmaceutically acceptable salt, a solvate and/or a hydrate thereof, wherein the disease includes a disease caused by a coronavirus.
  • the disease caused by a coronavirus especially SARS coronavirus (SARS-CoV) and SARS-CoV-2 includes but is not limited to a respiratory system disease (e.g., simple infection (such as fever, cough and sore throat), pneumonia, acute respiratory infection, severe acute respiratory infection (SARI), hypoxic respiratory failure, acute respiratory distress syndrome, sepsis, septic shock, severe acute respiratory syndrome (SARS), etc.)).
  • a respiratory system disease e.g., simple infection (such as fever, cough and sore throat), pneumonia, acute respiratory infection, severe acute respiratory infection (SARI), hypoxic respiratory failure, acute respiratory distress syndrome, sepsis, septic shock, severe acute respiratory syndrome (SARS), etc.
  • the present application also relates to use of a pharmaceutical composition in manufacture of a medicament for treating a disease or an infection caused by a coronavirus, especially SARS coronavirus (SARS-CoV) and SARS-CoV-2 (e.g., a respiratory disease (e.g., simple infection (such as fever, cough and sore throat), pneumonia, acute respiratory infection, severe acute respiratory infection (SARI), hypoxic respiratory failure, acute respiratory distress syndrome, sepsis, septic shock, severe acute respiratory syndrome (SARS), etc.)), wherein the pharmaceutical composition comprises a compound represented by Formula I, a geometric isomer, a pharmaceutically acceptable salt, a solvate and/or a hydrate thereof,
  • SARS-CoV SARS coronavirus
  • SARS-CoV-2 e.g., a respiratory disease (e.g., simple infection (such as fever, cough and sore throat), pneumonia, acute respiratory infection, severe acute respiratory infection (SARI), hypoxic respiratory failure, acute respiratory distress syndrome, sepsis
  • the pharmaceutical composition further comprises a pharmaceutically acceptable carrier or excipient.
  • the pharmaceutical composition is a solid preparation, an injection, an external preparation, a spray, a liquid preparation, or a compound preparation.
  • the present application also relates to use of a pharmaceutical composition in manufacture of a medicament as a coronavirus inhibitor, wherein the pharmaceutical composition comprises the compound represented by Formula I, a geometric isomer, a pharmaceutically acceptable salt, a solvate and/or a hydrate thereof,
  • the pharmaceutical composition further comprises a pharmaceutically acceptable carrier or excipient.
  • the pharmaceutical composition is a solid preparation, an injection, an external preparation, a spray, a liquid preparation, or a compound preparation.
  • the present application also relates to use of a pharmaceutical composition in manufacture of a medicament for inhibiting the replication or reproduction of coronavirus in a cell (e.g., a cell of mammal), wherein the pharmaceutical composition comprises the compound represented by Formula I, a geometric isomer, a pharmaceutically acceptable salt, a solvate and/or a hydrate thereof,
  • the pharmaceutical composition further comprises a pharmaceutically acceptable carrier or excipient.
  • the pharmaceutical composition is a solid preparation, an injection, an external preparation, a spray, a liquid preparation, or a compound preparation.
  • the present application also relates to the compound represented by Formula I, a geometric isomer, a pharmaceutically acceptable salt, a solvate and/or a hydrate thereof, for use in treating a disease or an infection caused by a coronavirus, especially SARS coronavirus (SARS-CoV) and SARS-CoV-2 (e.g., including but not limited to respiratory disease (e.g., simple infection (such as fever, cough and sore throat), pneumonia, acute respiratory infection, severe acute respiratory infection (SARI), hypoxic respiratory failure, acute respiratory distress syndrome, sepsis, septic shock, severe acute respiratory syndrome (SARS), etc.)).
  • respiratory disease e.g., simple infection (such as fever, cough and sore throat), pneumonia, acute respiratory infection, severe acute respiratory infection (SARI), hypoxic respiratory failure, acute respiratory distress syndrome, sepsis, septic shock, severe acute respiratory syndrome (SARS), etc.
  • respiratory disease e.g., simple infection (such as fever, cough and sore throat), pneumonia,
  • the present application also relates to the compound represented by Formula I, a geometric isomer, a pharmaceutically acceptable salt, a solvate and/or a hydrate thereof, for use as a coronavirus inhibitor.
  • the present application also relates to the compound represented by Formula I, a geometric isomer, a pharmaceutically acceptable salt, a solvate and/or a hydrate thereof, for use in inhibiting the replication or reproduction of coronavirus in a cell (e.g., a cell of mammal).
  • the present application also relates to a pharmaceutical composition, for use in treating a disease or an infection caused by a coronavirus, especially SARS coronavirus (SARS-CoV) and SARS-CoV-2 (e.g., a respiratory system disease (e.g., simple infection (such as fever, cough and sore throat), pneumonia, acute respiratory infection, severe acute respiratory infection (SARI), hypoxic respiratory failure, acute respiratory distress syndrome, sepsis, septic shock, severe acute respiratory syndrome (SARS), etc.)), wherein the pharmaceutical composition comprises the compound represented by Formula I, a geometric isomer, a pharmaceutically acceptable salt, a solvate and/or a hydrate thereof,
  • SARS-CoV SARS coronavirus
  • SARS-CoV-2 e.g., a respiratory system disease (e.g., simple infection (such as fever, cough and sore throat), pneumonia, acute respiratory infection, severe acute respiratory infection (SARI), hypoxic respiratory failure, acute respiratory distress syndrome, sepsis, septic
  • the pharmaceutical composition further comprises a pharmaceutically acceptable carrier or excipient.
  • the pharmaceutical composition is a solid preparation, an injection, an external preparation, a spray, a liquid preparation, or a compound preparation.
  • the present application also relates to a pharmaceutical composition, for use as a coronavirus inhibitor, wherein the pharmaceutical composition comprises the compound represented by Formula I, a geometric isomer, a pharmaceutically acceptable salt, a solvate and/or a hydrate thereof,
  • the pharmaceutical composition further comprises a pharmaceutically acceptable carrier or excipient.
  • the pharmaceutical composition is a solid preparation, an injection, an external preparation, a spray, a liquid preparation, or a compound preparation.
  • the present application also relates to a pharmaceutical composition, for use in inhibiting the replication or reproduction of coronavirus in a cell (e.g., a cell of mammal), wherein the pharmaceutical composition comprises the compound represented by Formula I, a geometric isomer, a pharmaceutically acceptable salt, a solvate and/or a hydrate thereof,
  • the pharmaceutical composition further comprises a pharmaceutically acceptable carrier or excipient.
  • the pharmaceutical composition is a solid preparation, an injection, an external preparation, a spray, a liquid preparation, or a compound preparation.
  • the coronavirus in the present application is SARS coronavirus (SARS-CoV) or SARS-CoV-2.
  • the coronavirus in the present application is SARS-CoV-2.
  • the disease caused by a coronavirus in the present application is a disease caused by a SARS-CoV-2, namely COVID-19.
  • the disease caused by a coronavirus in the present application is atypical pneumonia caused by a SARS coronavirus (SARS-CoV).
  • SARS-CoV SARS coronavirus
  • the mammal in the present application includes bovine, equine, caprid, suidae, canine, feline, rodent, primate, for example, human, cat, dog or pig.
  • 2019 novel Coronavirus 2019-nCoV
  • SARS-CoV-2 severe acute respiratory syndrome coronavirus 2
  • the term “therapeutically effective amount” or “prophylactically effective amount” refers to an amount that is sufficient to treat or prevent a patient's disease but is sufficiently low to avoid serious side effects (at a reasonable benefit/risk ratio) within a reasonable medical judgment.
  • the therapeutically effective amount of the compound will change according to the factors such as the selected specific compound (e.g., considering the efficacy, effectiveness, and half-life of compound), the selected administration route, the treated disease, the severity of the treated disease, the patient's age, size, weight and physical disease, medical history, duration of treatment, nature of concurrent therapy, desired therapeutic effect, etc., but can still be routinely determined by those skilled in the art.
  • the specific dosage and method of using the compound represented by Formula I, a geometric isomer, a pharmaceutically acceptable salt, a solvate and/or a hydrate thereof for different patients depends on many factors, including the patient's age, weight, gender, natural health status, nutritional status, active strength of drug, administration time, metabolic rate, severity of disease, and subjective judgment of physician.
  • a dosage between 0.001-1000 mg/kg body weight/day.
  • the pharmaceutical composition described in the present application can be prepared into various forms according to different administration routes.
  • the pharmaceutical composition can be administered in any one of the following routes: oral administration, spray inhalation, rectal administration, nasal administration, buccal administration, vaginal administration, topical administration, parenteral administration such as subcutaneous, intravenous, intramuscular, intraperitoneal, intrathecal, intraventricular, intrasternal and intracranial injection or infusion, or administration with the help of an explant reservoir, wherein the preferred administration route is oral, intraperitoneal or intravenous administration.
  • the compound represented by Formula I, a geometric isomer, a pharmaceutically acceptable salt, a solvate and/or a hydrate thereof can be prepared into any form of orally acceptable preparation, including but not limited to a tablet, a capsule, an aqueous solution or an aqueous suspension.
  • the carrier for use in a tablet generally includes lactose and corn starch, and a lubricant such as magnesium stearate can also be added.
  • the diluent for use in a capsule generally includes lactose and dry corn starch.
  • the aqueous suspension is usually used by mixing an active ingredient with a suitable emulsifier and a suitable suspending agent. If necessary, a sweetener, a flavoring agent or a coloring agent can also be added to the above-mentioned forms of oral preparation.
  • the compound represented by Formula I, a geometric isomer, a pharmaceutically acceptable salt, a solvate, and/or a hydrate thereof can generally be prepared in a form of suppository, which is prepared by mixing the drug with a suitable non-irritating excipient.
  • the excipient is present in solid state at room temperature, but melts at the rectal temperature to release the drug.
  • excipient includes cocoa butter, beeswax and polyethylene glycol.
  • the compound represented by Formula I, a geometric isomer, a pharmaceutically acceptable salt, a solvate and/or a hydrate thereof can be prepared in various forms of topical preparations according to different affected-surfaces or organs, the specific instructions are as follows:
  • the compound represented by Formula I When topically administered to eye, the compound represented by Formula I, a geometric isomer, a pharmaceutically acceptable salt, a solvate and/or a hydrate thereof can be formulated into a preparation form such as micronized suspension or solution, the carrier used is isotonic sterile saline with a certain pH, and a preservative such as benzyl chloride alkoxide may or may not be added.
  • the compound can also be prepared in a form of ointment such as vaseline ointment.
  • the compound represented by Formula I, a geometric isomer, a pharmaceutically acceptable salts, a solvate and/or a hydrate thereof can be prepared into a suitable form such as an ointment, a lotion or a cream, in which the active ingredient is suspended or dissolved in one or more carriers.
  • the carrier for use in an ointment includes, but is not limited to: mineral oil, liquid petrolatum, white petrolatum, propylene glycol, polyethylene oxide, polypropylene oxide, emulsifying wax, and water.
  • the carrier for use in a lotion or a cream includes, but is not limited to: mineral oil, sorbitan monostearate, Tween-60, cetyl ester wax, hexadecenyl aryl alcohol, 2-octyldodecanol, benzyl alcohol and water.
  • the compound represented by Formula I When topically administered to lower intestinal tract, the compound represented by Formula I, a geometric isomer, a pharmaceutically acceptable salt, a solvate and/or a hydrate thereof can be prepared into a form such as rectal suppository as described above or a suitable enema preparation form, in addition, a topical transdermal patch can also be used.
  • the compound represented by Formula I, a geometric isomer, a pharmaceutically acceptable salt, a solvate and/or a hydrate thereof can also be administered in a preparation form of sterile injection, including sterile injectable aqueous solution or oil suspension, or sterile injectable solutions, wherein the usable carrier and solvent includes water, Ringer's solution and isotonic sodium chloride solution.
  • a sterilized non-volatile oil such as monoglyceride or diglyceride can also be used as solvent or suspension media.
  • the drugs of the above various preparation forms can be prepared according to conventional methods in the pharmaceutical field.
  • FIG. 1 shows that Favipiravir can effectively reduce the viral nucleic acid load in Vero E6 cells infected by SARS-CoV-2.
  • FIG. 1 shows that Favipiravir can reduce the viral RNA load in the cells 48 h after the cells were infected by SARS-CoV-2, and the inhibitory activity is dose-dependent; in (a), the ordinate is the copy number of viral RNA in the sample, and the abscissa is the drug concentration; (b) shows that Favipiravir has no observable cytotoxicity 48 h after the cells are treated at the tested concentration; in (b), the ordinate is the percentage of cell viability relative to the vehicle control group (only cells, no drug added), and the abscissa is the drug concentration.
  • FIG. 2 shows that Favipiravir can effectively protect SARS coronavirus-infected mice from death.
  • the mice were intraperitoneally injected with Favipiravir once a day 4 hours after challenge, and the vehicle control group was injected with the same volume of solvent. It can be seen that all mice of the vehicle control group died, while the mice of the Favipiravir treatment group survived, and the survival rate is dose-dependent.
  • Vero E6 cells purchased from ATCC, Catalog No. 1586 were placed into a 24-well plate and incubated for 24 hours, then virus infection was carried out, specifically, SARS-CoV-2 (2019-nCoV) virus (nCoV-2019BetaCoV/Wuhan/WIV04/2019 strain, provided by Wuhan Institute of Virology, Chinese Academy of Sciences) was diluted with 2% cell maintenance solution (formulation: FBS (purchased from Gibco, Catalog No.: 16000044) was added to MEM (purchased from Gibco, Article No: 10370021) by a volume ratio of 2%, thereby obtaining the 2% cell maintenance solution) to corresponding concentration, and then added to the 24-well plate so that each well contained a viral load of 100TCID 50 .
  • SARS-CoV-2 2019-nCoV virus
  • MEM purchasedd from Gibco, Article No: 10370021
  • the Favipiravir (purchased from Selleck Chemicals, Catalog No.: S7975) was diluted with 2% cell maintenance solution to the corresponding concentrations and added to corresponding wells, so that the final drug concentrations were 100 ⁇ M, 33 ⁇ M, 11 ⁇ M, 3.7 ⁇ M, 1.23 ⁇ M, 0.41 ⁇ M, 0.14 ⁇ M, respectively, then the plate was put in 37° C., 5% CO 2 incubator and continuously cultured for 48 h, and the cell vehicle control group was added with only 2% cell maintenance solution without any test drug.
  • RNA extraction kit was purchased from Qiagen, Catalog No.: 74106.
  • the consumptive materials spin column, RNase-free 2 ml collection tube, etc.
  • reagents RLT, RW1, RPE, RNase-free water, etc.
  • step 2) the supernatant obtained in step 1) was added with an equal volume of 70% ethanol and mixed well;
  • step 2) the mixed solution obtained in step 2) above was transferred to a RNase-free spin column, centrifuged at 12000 rpm for 15 s, and the waste liquid was discarded;
  • step 8 the spin column was placed in a new RNase-free 2 ml collection tube, and centrifugation was carried out at 12000 rpm for 1 min to dry the spin column, and then the entire spin column was transferred to the 1.5 ml collection tube of step 8);
  • step 8) the spin column dried in step 7) was placed in a new 1.5 ml collection tube, added with 30 ⁇ l of RNase-free water, and centrifuged at 12000 rpm for 2 min, the obtained eluent contained the corresponding RNA, and was added with RNase inhibitor (purchased from NEB, Catalog No.: M0314L), and detected with Nano Drop (purchased from Thermo scientific, Nano Drop One) to determine each RNA concentration.
  • RNase inhibitor purchased from NEB, Catalog No.: M0314L
  • Nano Drop purchased from Thermo scientific, Nano Drop One
  • the reverse transcription kit (PrimeScriptTM RT reagent Kit with gDNA Eraser, Catalog No. RR047Q) produced by TaKaRa Company was used for RNA reverse transcription. The steps were as follows.
  • RNA samples from each experimental group were collected, and 1 ⁇ g thereof was taken and subjected to reverse transcription.
  • 2 ⁇ l of 5 ⁇ gDNA Eraser Buffer was added to the RNA sample of each experimental group, the reaction system was supplemented with RNase Free water to 10 ⁇ l, mixed well, and subjected to 42° C. water bath for 2 min to remove the gDNA that might exist in the sample;
  • ⁇ circle around (2) ⁇ Reverse transcription the sample obtained in ⁇ circle around (1) ⁇ was added with appropriate amounts of enzyme, primer Mix and reaction buffer, supplemented with RNase Free water to an volume of 20 ⁇ l, reacted under 37° C. water bath for 15 min, then put in 85° C. water bath for 5 sec, thereby obtaining cDNA via transcription.
  • Fluorescence quantitative PCR was used to detect the copy number per ml of the original virus solution.
  • the reaction system was mixed using TB Green Premix (Takara, Cat #RR820A), and the amplification reaction and reading were carried out with StepOne Plus Real-time PCR instrument (brand: ABI). The copy number contained in per ml of the original virus solution was calculated. The steps were as follows:
  • the plasmid pMT-RBD (the plasmid was provided by Wuhan Institute of Virology, Chinese Academy of Sciences) was diluted to 5 ⁇ 10 8 copies/ ⁇ L, 5 ⁇ 10 7 copies/ ⁇ L, 5 ⁇ 10 6 copies/ ⁇ L, 5 ⁇ 10 5 copies/ ⁇ L, 5 ⁇ 10 4 copies/ ⁇ L, 5 ⁇ 10 3 copies/ ⁇ L, 5 ⁇ 10 2 copies/ ⁇ L. 2 ⁇ L standard or cDNA template was taken for qPCR reaction.
  • RBD-qF CAATGGTTTAACAGGCACAGG
  • RBD-qR CTCAAGTGTCTGTGGATCACG
  • Cycle parameters 95° C. for 15 seconds, 54° C. for 15 seconds, 72° C. for 30 seconds, for a total of 40 cycles.
  • Vero E6 (ATCC) cells were placed in a 96-well plate and incubated at 37° C. for 8 hours.
  • the drug was diluted with DMSO to an appropriate concentration of mother liquor, and then diluted with MEM medium (purchased from Gibco, Catalog No. 10370021) containing 2% FBS (purchased from Gibco, Catalog No. 16000044) to the same concentration as that for the drug treatment.
  • MEM medium purchased from Gibco, Catalog No. 10370021
  • FBS purchased from Gibco, Catalog No. 16000044
  • the original medium in the 96-well plate was discarded, 100 ⁇ L of drug-containing MEM medium was added to the cells, and three replicate wells were prepared for each concentration.
  • Vehicle control DMSO and medium were added to the cell wells, without adding drug
  • blank control DMSO and medium were added to the wells, without cells
  • Cell activity (%) ( A (drug treatment group) ⁇ A (blank control) )/( A (vehicle control) ⁇ A (blank control) ) ⁇ 100%
  • the results of the virus proliferation inhibition experiment showed that the test compound at concentrations of 100 ⁇ M, 33 ⁇ M, 11.1 ⁇ M and 3.7 ⁇ M could effectively inhibit the replication of the SARS-CoV-2 virus genome in the infected supernatant (Table 1 and FIG. 1 )
  • the cytotoxicity test results showed that the treatment of the test compound (Favipiravir) did not change the cell viability at all test concentrations, that was, the test compound had no toxic effect on the cells at all test concentrations (Table 2 and FIG. 1 ).
  • mice aged 3-4 weeks and weighed 9-13 g were randomly divided into 4 groups, namely the virus control group, the high-dose administration group, the middle-dose administration group and the low-dose administration group, 10 mice per group, marked with ear studs.
  • 0.5% CMC-Na was used as solvent to dissolve Favipiravir.
  • the drug Favipiravir was accurately weighed, added with an appropriate amount of 0.5% CMC-Na solution, alternately treated under vortex and ultrasonic condition for 15 min until the sample was a uniform particle suspension, then diluted with 0.5% CMC-Na by 2-fold, and the dilution was carried out according to administration dose of 200 mg/kg, 100 mg/kg and 50 mg/kg, respectively.
  • the resultant drug solutions were stored at 4° C. for later use.
  • the challenge was carried out by intraperitoneal injection, i.e., each mouse was intraperitoneally injected with SARS coronaviruses (provided by the Academy of Military Medicine) at a challenge dose of 1*10 6 PFU, wherein the viruses were diluted with normal saline to the required dose.
  • the intraperitoneal administration was carried out once 4 h, 24 h, 48 h, 72 h, 96 h, 120 h and 144 h after the challenge, respectively, in which the administration doses were high dose of 200 mg/kg, medium dose of 100 mg/kg and low dose of 50 mg/kg, and the virus control group was given the same volume of 0.5% CMC-Na solvent.
  • the weighing and recording were carried out at fixed time points every day, the death of mice was recorded at the same time, and the survival curve was drawn, as shown in FIG. 2 .
  • mice The results of in vivo experiments showed that the terminal survival rate of mice was in a dose-effect-dependent relationship with the dose (Table 3 and FIG. 2 ), indicating that the treatment with the test compound Favipiravir can effectively protect mice from SARS coronavirus infection-caused death.

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