Indomethacin, a drug with known antiviral activity against SARS-CoVs neglected during the COVID-19 pandemic

At the beginning of COVID-19 pandemic, due to the lack of guidance from evidence-based medicine on how to treat the infected patients, the medical class faced significant difficulties, not only with the unknown infection but also with the great number of cases. This led to a great number of hospitalizations and deaths. It would have been necessary to try drugs already available on the market, which might be effective against SARS-CoV-2. This is a short review of studies in the scientific literature dealing with the use of indomethacin as an antiviral drug against SARS-CoVs. We revised studies taken from the scientific literature in PubMed, Science Direct, Scopus, ResearchGate, Google Scholar etc., describing the effects of indomethacin as an antiviral drug against SARS-CoVs. To search for studies, we used the keywords: SARS-CoV, off-label drug, pandemic emergence, repurposed drug, Absence of EBM, Antiviral, Indomethacin, and Mechanisms. Among the studies reviewed, there is an interesting experimental study, published in 2006 by an Italian group, which considered the problem at the time of the previous SARS-CoV epidemic, that clearly demonstrated an antiviral effect of indomethacin, both in vitro and in vivo, against SARS-CoV. Two other studies, both clinical, one retrospective observational, and the other a prospective randomized trial comparing indomethacin with paracetamol, also showed good effects of indomethacin in the treatment of patients with COVID-19. On the basis of these notices, we wonder why, in such an emergency situation, indomethacin was not taken into consideration and was not tried in the treatment of COVID-19.