Bromhexine is a potential drug for COVID-19; From hypothesis to clinical trials

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Abstract

COVID-19 (novel coronavirus disease 2019), caused by the SARS-CoV-2 virus, has various clinical manifestations and several pathogenic pathways. Although several therapeutic options have been used to control COVID-19, none of these medications have been proven to be a definitive cure. Transmembrane serine protease 2 (TMPRSS2) is a protease that has a key role in the entry of SARS-CoV-2 into host cells. Following the binding of the viral spike (S) protein to the angiotensin-converting enzyme 2 (ACE2) receptors of the host cells, TMPRSS2 processes and activates the S protein on the epithelial cells. As a result, the membranes of the virus and host cell fuse. Bromhexine is a specific TMPRSS2 inhibitor that potentially inhibits the infectivity cycle of SARS-CoV-2. Moreover, several clinical trials are evaluating the efficacy of bromhexine in COVID-19 patients. The findings of these studies have shown that bromhexine is effective in improving the clinical outcomes of COVID-19 and has prophylactic effects by inhibiting TMPRSS2 and viral penetration into the host cells. Bromhexine alone cannot cure all of the symptoms of SARS-CoV-2 infection. However, it could be an effective addition to control and prevent the disease progression along with other drugs that are used to treat COVID-19. Further studies are required to investigate the efficacy of bromhexine in COVID-19.

About the authors

S. Bahadoram

Thalassemia and Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences

Author for correspondence.
Email: saraBahadoram@yahoo.com
ORCID iD: 0000-0001-9531-8270

Sara Bahadoram, MD, Assistant Professor of Pediatrics

Golestan Street, 15794–61357  Ahvaz

Iran, Islamic Republic of

B. Keikhaei

Thalassemia and Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences

Email: saraBahadoram@yahoo.com
ORCID iD: 0000-0002-3087-7650

Bijan Keikhaei, MD, Professor of Pediatric Hematology and Oncology

Golestan Street, 15794–61357 Ahvaz, Iran

Iran, Islamic Republic of

M. Bahadoram

Thalassemia and Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences

Email: mohammadbahadoram@yahoo.com
ORCID iD: 0000-0002-7106-9799

Mohammad Bahadoram, MD, Researcher

Golestan Street, 15794–61357 Ahvaz

Iran, Islamic Republic of

M.-R. Mahmoudian-Sani

Thalassemia and Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences

Email: mohamadsani495@gmail.com
ORCID iD: 0000-0002-1096-5661

Mohammad-Reza Mahmoudian-Sani, PhD, Assistant Professor of Molecular Medicine

Golestan Street, 15794–61357 Ahvaz

Iran, Islamic Republic of

S. Hassanzadeh

Thalassemia and Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences

Email: shak.hassazadeh@gmail.com
ORCID iD: 0000-0002-5091-5191

Shakiba Hassanzadeh, MD, Researcher

Golestan Street, 15794–61357  Ahvaz

Iran, Islamic Republic of

A. Saeedi-Boroujeni

Ahvaz Jundishapur University of Medical Sciences; Abadan University of Medical Sciences; ImmunologyToday, Universal Scientific Education and Research Network (USERN)

Email: ali.immune1989@gmail.com
ORCID iD: 0000-0001-6167-1412

Ali Saeedi-Boroujeni, PhD Candidate of Immunology, Department of Immunology, Faculty of Medicine

Golestan Street, 15794–61357 Ahvaz

Iran, Islamic Republic of

K. Alikhani

Thalassemia and Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences

Email: alikhaninadia@gmail.com
ORCID iD: 0000-0001-7151-4170

Kosar Alikhani, Pharm.D, Researcher

Golestan Street, 15794–61357 Ahvaz

Iran, Islamic Republic of

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Copyright (c) 2022 Bahadoram S., Keikhaei B., Bahadoram M., Mahmoudian-Sani M., Hassanzadeh S., Saeedi-Boroujeni A., Alikhani K.

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This work is licensed under a Creative Commons Attribution 4.0 International License.

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