Naproxen against coronavirus (and chloroquine)

Response to the emerging novel coronavirus outbreak.

"Based on the fact that the COVID-19 virus is single-stranded RNA virus and Naproxen has an antiviral activity via inhibiting nucleoprotein (NP) binding to RNA in the replication process of RNA-viruses like influenza A/B, the use of Naproxen as a probable agent for control of widespread novel coronavirus infection may be assumed."
https://www.bmj.com/content/368/bmj.m406/rr-9

I found a 2013 study suggesting benefit of naproxen (and another for indomethacin) against the coronavirus family (SARS etc.) It seems like an easy risk-benefit decision, not that there aren't significant risks of prolonged Naprosyn administration (those with PUD at risk for GI bleed, or on anticoagulant, or at significant risk of MI.)

I love how they modeled the receptor, then searched out putative drugs that might block that receptor in 3-D models. Very sophisticated computer sleuthing.

Pain reliever shows anti-viral activity against flu:

"The nucleoprotein's three dimensional structure, solved in 2006, provided the basis for searching for new drugs that could interfere with its action. The researchers did a virtual screening within the Sigma-Aldrich online catalog of biochemicals. That screening identified Naproxen, better known as the over-the-counter pain reliever Aleve, and as expected, it bound to the nucleoprotein, and impeded RNA binding"

"naproxen blocks the RNA binding groove of the nucleoprotein, preventing formation of the ribonucleoprotein complex"

https://www.sciencedaily.com/releases/2013/03/130321151926.htm

Structure-Based Discovery of the Novel Antiviral Properties of Naproxen against the Nucleoprotein of Influenza A Virus.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3632891/

Indomethacin has a potent antiviral activity against SARS coronavirus.

https://www.ncbi.nlm.nih.gov/m/pubmed/17302372/

And of course, someone is studying it:

Efficacy of Addition of Naproxen in the Treatment of Critically Ill Patients Hospitalized for COVID-19 Infection

https://clinicaltrials.gov/ct2/show/NCT04325633

Tissue culture of bronchial cells shows benefit:

"In VeroE6 cells and reconstituted human primary respiratory epithelium models of SARS-CoV-2 infection, naproxen inhibited viral replication and protected the bronchial epithelia against SARS-CoV-2 induced-damage."

https://www.biorxiv.org/content/10.1101/2020.04.30.069922v1

Seems to be safe to give it - 

"At present there is no evidence of severe adverse events, acute health care utilization, long-term survival, or quality of life in patients with COVID-19, as a result of the use of NSAIDs. "

https://www.who.int/news-room/commentaries/detail/the-use-of-non-steroidal-anti-inflammatory-drugs-(nsaids)-in-patients-with-covid-19

This is what led me to search for NSAIDS and coronavirus in the first place. 

Cyclooxygenase‐2 facilitates dengue virus replication and serves as a potential target for developing antiviral agents .

"Cyclooxygenase-2 (COX-2) is one of the important mediators of inflammation in response to viral infection, and it contributes to viral replication"

https://www.nature.com/articles/srep44701

Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro.
"...[monkey] cells were infected with nCoV-2019BetaCoV...Efficacies were evaluated by quantification of viral copy numbers [by] PCR...chloroquine...potently blocked virus infection at low-micromolar concentration"
https://www.nature.com/articles/s41422-020-0282-0