A contribution to the hypothesis of nicotinic challenge as therapeutic option for COVID-19 patients

The pandemic caused by SARS-CoV-2 represents an open and unresolved challenge for the global health system. The need to identify drugs that demonstrate efficacy in countering both the mechanisms of interaction of SARS-CoV-2 with host cells and to control the devastating inflammatory phenomena that characterize the late stages of viral infection, requires increasingly urgent answers. The biomedical research approach based on the repurposing of already approved drugs seems to be one of the most viable strategies in this struggle. In this work, through a computational pharmacology approach and on the basis of what has been recently reported on the potential of nicotinic receptors in countering both phases of COVID-19, we propose a hypothesis aimed at widening the spectrum of pharmacological tools currently available to doctors. Our proposal specifically concerns the possibility of using tropisetron, a 5-HT3 receptor antagonist at the same time positive allosteric interactor of the nicotinic alpha-7 acetylcholine receptor, in order to inhibit the virus-host interaction and restore the physiological control of the excessive inflammation caused by SARS-CoV-2 infection.