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Acyclovir for SARS-CoV-2: An Old Drug with a New Purpose

Vina S. Baker

Currently, remdesivir is the only Food and Drug Administration approved antiviral for COVID-19. Recent reports of viral mutations in the novel coronavirus are leading to a more infectious agent than at the beginning of the pandemic. Presented in this article are cases that were treated with an old drug, acyclovir. To date, 38 patients have received treatment with acyclovir. The following 4 cases highlight the benefits of acyclovir. 3 of these cases had severe pulmonary disease and 1 had splenomegaly. 1 of the 3 pulmonary cases had worsening pulmonary involvement after hospitalization during which remdesivir in conjunction with dexamethasone was used. Acyclovir has proven to be effective, safe and inexpensive in 29 patients. 9 patients are still under treatment. No adverse effects or death have been observed with this treatment thus far. Further studies comparing acyclovir to remdesivir are needed to validate benefits from acyclovir for SARS-CoV-2 infection.