Disulfiram associated with lower risk of Covid-19

The results of this study suggest that disulfiram use contributes to a reduced incidence of COVID-19. Given the known anti-inflammatory and anti-protease effects of disulfiram, its low cost, low side effects,

Disulfiram associated with lower risk of Covid-19

Disulfiram associated with lower risk of Covid-19: a retrospective cohort study

Objective To investigate the potential effects of disulfiram on the incidence and severity of COVID-19.

Design Retrospective cohort study from February 20, 2020 to February 1, 2021.

Setting Veterans Health Administration. Veterans who had visited a VA primary care provider in the 18 months before their first SARS-CoV-2 test.

Participants 2,233 Veterans with at least one SARS-CoV-2 laboratory (positive or negative) test result on or after February 20, 2020 and at least one pharmacy record for disulfiram on or after February 20, 2019 and 941,894 Veterans without a pharmacy record for disulfiram.

Exposure Treatment with disulfiram

Main Outcome Positive test result for SARS-CoV-2

Results A multivariable Cox regression analysis adjusted for age, gender, race/ethnicity, region, diagnosis of an alcohol use disorder, and Charlson comorbidity score resulted in a reduced hazard of COVID-19 infection with disulfiram use, with a hazard ratio of 0.66 and 95% confidence interval of 0.57 to 0.76 (P < 0.001).

Conclusions and Relevance The results of this study suggest that disulfiram use contributes to a reduced incidence of COVID-19. Given the known anti-inflammatory and anti-protease effects of disulfiram, its low cost, low side effects, and general availability, it is reasonable and urgent to initiate accelerated clinical trials to assess the effect of disulfiram on infection and the development of advanced disease.

Nathanael Fillmore, Steven Bell, Ciyue Shen, Vinh Nguyen, Jennifer La, Maureen Dubreuil, Judith Strymish, Mary Brophy,  Gautam Mehta,  Hao Wu,  Judy Lieberman, Nhan Do,  Chris Sander  medRxiv 2021.03.10.21253331; doi: https://doi.org/10.1101/2021.03.10.21253331