Several adamantanes have established actions against coronaviruses. Amantadine, rimantadine, bananins and the structurally related memantine are effective against human respiratory coronavirus HCoV-OC43, bovine coronavirus and severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1) and a spiroadamantane amine is effective against the coronavirus strain 229E. Molecular docking studies suggest that amantadine may block the viral E protein channel, leading to impaired viral propagation. Additionally, amantadine analogues may inhibit entry of the virus into the host cell by increasing the pH of the endosomes and thus inhibiting the action of host cell proteases such as Cathepsin L. High-throughput drug screen gene expression analysis identified compounds able to down-regulate Cathepsin L expression where the fifth most potent agent of 466 candidates was amantadine. Amantadine inhibits severe acute respiratory syndrome coronavirus 2 replication in vitro but does not inhibit the binding of the spike protein to ACE2. Adamantanes also may act against coronaviruses including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) via antagonism of glutamate (NMDA) and the α-7 subtype of the nicotinic acetylcholine receptor located on bronchial and alveolar epithelial cells. As an NMDA receptor antagonist, memantine has the potential to inhibit entry of SARS-CoV-2 into these cell populations. Amantadine and memantine are widely employed for the treatment of neurodegenerative diseases and a pathophysiologic link between the antiviral and anti-Parkinson actions of amantadine has been entertained. Case reports involving 23 patients with reverse transcription polymerase chain reaction-confirmed coronavirus disease 2019 (COVID-19) and a range of co-morbidities including type 2 diabetes mellitus, Parkinson’s disease, multiple sclerosis and severe cognitive impairment reveal significant potential benefits of amantadine and memantine for the prevention and/or treatment of coronavirus disease 2019 and its neurological complications.

几种金刚烷胺已针对冠状病毒发挥作用。金刚烷胺、金刚乙胺、巴南宁和结构相关的美金刚胺可有效对抗人呼吸道冠状病毒 HCoV-OC43、牛冠状病毒和严重急性呼吸综合征冠状病毒 1 (SARS-CoV-1)，螺金刚烷胺可有效对抗冠状病毒株 229E。分子对接研究表明金刚烷胺可能会阻断病毒 E 蛋白通道，导致病毒传播受损。此外，金刚烷胺类似物可以通过增加内涵体的 pH 值来抑制病毒进入宿主细胞，从而抑制宿主细胞蛋白酶（如组织蛋白酶 L）的作用。高通量药物筛选基因表达分析鉴定出能够下调病毒的化合物组织蛋白酶 L 表达，466 种候选药物中第五强的药物是金刚烷胺。金刚烷胺在体外抑制严重急性呼吸综合征冠状病毒 2 复制，但不抑制刺突蛋白与 ACE2 的结合。金刚烷还可以通过拮抗谷氨酸 (NMDA) 和位于支气管和肺泡上皮细胞上的烟碱乙酰胆碱受体 α-7 亚型来对抗冠状病毒，包括严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2)。作为 NMDA 受体拮抗剂，美金刚有可能抑制 SARS-CoV-2 进入这些细胞群。金刚烷胺和美金刚广泛用于治疗神经退行性疾病，金刚烷胺的抗病毒和抗帕金森作用之间存在病理生理学联系。病例报告涉及 23 名经逆转录聚合酶链反应确诊的 2019 年冠状病毒病 (COVID-19) 患者以及一系列合并症（包括 2 型糖尿病、帕金森病、多发性硬化症和严重认知障碍）的患者，揭示了金刚烷胺和金刚烷胺的显着潜在益处美金刚用于预防和/或治疗 2019 年冠状病毒病及其神经系统并发症。