Codivir suppresses SARS-Cov-2 viral replication and stabilizes clinical outcome: In vitro and Phase I clinical trial results
Authors:   Faculty of Medicine, Hebrew University Hadassah Medical Center, and the Department of Medicine, Hadassah Medical Center Jerusalem, Israel, Kolben Yotam , Finkelshtein Eynat ,   Code Pharma, The Netherlands, Naftali Esmira ,   Code Pharma, The Netherlands, Kenig Ariel ,   Faculty of Medicine, Hebrew University Hadassah Medical Center, and the Department of Medicine, Hadassah Medical Center Jerusalem, Israel, Kessler Asa ,   Faculty of Medicine, Hebrew University Hadassah Medical Center, and the Department of Medicine, Hadassah Medical Center Jerusalem, Israel, Cardoso Florentino ,   Hospital is Casa de Saúde - Vera Cruz, Brazil, Lisovoder Nadya ,   Code Pharma, The Netherlands, Schwartz Asaf ,   Faculty of Medicine, Hebrew University Hadassah Medical Center, and the Department of Medicine, Hadassah Medical Center Jerusalem, Israel, Elbirt Daniel ,   Clinical Immunology, Allergy and AIDS Center Kaplan Medical Center, Affiliated with Hadassah-Hebrew University Medical School Jerusalem, Rehovot, Israel, Maayan Shlomo ,   Division of infectious diseases, Barzilai University Medical Center, Ashkelon, Israel, Ilan Yaron ,   Faculty of Medicine, Hebrew University Hadassah Medical Center, and the Department of Medicine, Hadassah Medical Center Jerusalem, Israel
Published: July 2023

BACKGROUND: Treatment of severe acute respiratory distress syndrome coronavirus 2 (SARSCoV-2) remains a significant challenge in the face of increased worldwide morbidity and mortality. The acute illness caused by SARS-CoV-2 is initiated by a viral phase, followed by an inflammatory phase. Numerous anti-inflammatory and anti-viral therapies, with a relatively minor clinical effect, have been applied. Developing a safe and efficient direct anti-viral treatment is essential as it can block disease progression before significant complications ensue and potentially prevent transmission. AIM: The present phase 1 study aimed to determine the safety of Codivir, a newly developed anti-viral agent, and to preliminarily assess its anti-viral activity in patients infected by COVID-19. METHODS: In vitro studies were conducted to determine the direct anti-viral effect of Codivir using an immunofluorescence-based assay and to assess its cytotoxic effect by tetrazolium assay (MTT). In a phase I clinical trial, Codivir was administered for ten days in 12 patients who were followed for its safety. Patients were followed for clinical manifestations during administration. Sequential nasal viral PCR titers (Cycle Threshold, CT) were determined preceding and during treatment. RESULTS: In vitro, Codivir showed activity against SARS-CoV-2 with 90% viral replication suppression and minimal cytotoxicity. The anti-viral activity was demonstrated at the early stages of infection, postentry of the virus in the cell. Codivir was safe in all 12 patients in phase I clinical trial and significantly suppressed viral replication in 5/7 fully assessed patients, with an anti-viral effect noted as early as three days. SUMMARY: The present study's data support the safety of Codivir administration in humans and suggest its significant anti-COVID-19 effect. These results support the testing of the drug in more extensive controlled trials in patients with SARSCoV-2.