COVID-19: Famotidine, Histamine, Mast Cells, and Mechanisms.
Robert W MalonePhilip TisdallPhilip Fremont-SmithYongfeng LiuXi-Ping HuangKris M WhiteLisa MiorinElena Moreno Del OlmoAssaf AlonElise DelaforgeChristopher D HenneckerGuanyu WangJoshua PottelNora SmithJulie M HallGideon ShapiroAnthony MittermaierAndrew C KruseAdolfo García-SastreBryan L RothJill Glasspool-MaloneDarrell O RickePublished in: Research square (2020)
SARS-CoV-2 infection is required for COVID-19, but many signs and symptoms of COVID-19 differ from common acute viral diseases. Currently, there are no pre- or post-exposure prophylactic COVID-19 medical countermeasures. Clinical data suggest that famotidine may mitigate COVID-19 disease, but both mechanism of action and rationale for dose selection remain obscure. We explore several plausible avenues of activity including antiviral and host-mediated actions. We propose that the principal famotidine mechanism of action for COVID-19 involves on-target histamine receptor H 2 activity, and that development of clinical COVID-19 involves dysfunctional mast cell activation and histamine release.