Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Thalidomide-Revisited: Are COVID-19 Patients Going to be the Latest Victims of Yet Another Theoretical Drug-Repurposing?

Version 1 : Received: 2 May 2020 / Approved: 3 May 2020 / Online: 3 May 2020 (07:31:53 CEST)

A peer-reviewed article of this Preprint also exists.


The new pandemic coronavirus disease 2019 (COVID-19) is a worldwide threatening health issue. Early progression of this disease starts in the lung airways with an exaggerated inflammation, triggered by the viral infection and characterized by a “cytokine storm” that can lead to lethal lung injuries. In the absence of an effective anti-viral molecule and until the formulation of a successful vaccine, anti-inflammatory drugs might offer a complementary tool for controlling the associated complications and thus decreasing the subsequent fatalities. Drug repurposing for several molecules has emerged as a rapid temporary solution for COVID-19. Among these drugs, Thalidomide, a historically emblematic controversial molecule that harbors an FDA approval for treating Erythema Nodosum Leprosum (ENL) and multiple myeloma (MM). Based on only one-case report of positive outcomes in a patient treated amongst others with Thalidomide, two clinical trials on the efficacy and safety of Thalidomide in treating severe respiratory complications in COVID-19 patients were registered. Conversely, the absence of any substantial, promising evidence on Thalidomide usage in that context along with the discontinued studies on the efficiency of this drug in similar pulmonary diseases might cause a significant obstacle for carrying on clinical studies. In this review, we will discuss the theoretical effectiveness of this drug in attenuating inflammatory complications that are encountered in patients with COVID-19 while pinpointing the lack of evidence that is needed to move forward with this drug.


COVID-19; Cytokine Storm; Lung Injury; Thalidomide; Anti-inflammatory Drug


Medicine and Pharmacology, Epidemiology and Infectious Diseases

Comments (1)

Comment 1
Received: 13 May 2020
Commenter: (Click to see Publons profile: )
The commenter has declared there is no conflict of interests.
Comment: This manuscript summarized development of COVID-19 treatment, and pointed out drugs for treatment of the disease, especially Thalidomide. The authors therefore suggest the potential using of drug(s) for COVID-19. However, the author did not explain current situation of other drugs, especially chloroquine/hydroxychloroquine in this manuscript. In addition, no explanation of drug (A, B, or C) that suitable for use in combination with Thalidomide is available. This manuscript needs revisions as suggested above.

Line 39: “anti-viral molecule”: do you mean a drug? If an anti-viral drug is unavailable, why do you propose this drug to be combined with Thalidomide?

Line 60: “in 2012(Jin et al. 2020).” It should be “in 2012 (Jin et al. 2020).” Check entire the manuscript regarding the same errors.

Add recent information in lines 63-64 regarding the number of sufferers and deaths caused by COVID-19 all over the globe.

Add more information for chloroquine/hydroxychloroquine in lines 122-134. For example, see doi:10.20944/preprints202005.0057.v2.

Add at least one drug (anti-viral molecule?) for combination with Thalidomide in lines 297-303.
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