Heparan sulfate assists SARS-CoV-2 in cell entry and can be targeted by approved drugs in vitro

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Conflicts of Interest

Identified Weaknesses

Rating Explanation

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Paper Summary

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Heparin and Approved Drugs May Block SARS-CoV-2 Cell Entry (In Vitro)

This in vitro study found that heparan sulfate (HS), a molecule on the cell surface, helps SARS-CoV-2 enter cells. Several existing drugs, including mitoxantrone and a combination of raloxifene and tilorone, were shown to inhibit this HS-assisted viral entry in cell cultures.

Possible Conflicts of Interest

None identified. The study was funded by the Intramural Research Program of the National Institutes of Health.

Identified Weaknesses

In vitro study

The research was conducted in cell cultures, which doesn't fully represent the complexity of a human body. Further research, including animal models and clinical trials, is essential to confirm these findings and determine real-world efficacy and safety.

Focus on entry, not other viral processes

The study primarily focuses on viral entry. While crucial, this is only one stage of the viral life cycle. Drugs that block entry may not affect other processes like viral replication or immune evasion.

Potential toxicity of Mitoxantrone

Mitoxantrone, one of the identified drugs, is a chemotherapy drug with known toxicity. While the study suggests a therapeutic window in cell cultures, its safety and tolerability for COVID-19 treatment need thorough evaluation.

Rating Explanation

This is a well-designed in vitro study using multiple approaches to investigate a novel mechanism of SARS-CoV-2 entry. Identifying existing drugs that target this pathway offers promising therapeutic avenues. However, the in vitro nature and other limitations lower the rating, and further in vivo studies are crucial.

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