- Carlin, Aaron F;
- Beadle, James R;
- Clark, Alex E;
- Gully, Kendra L;
- Moreira, Fernando R;
- Baric, Ralph S;
- Graham, Rachel L;
- Valiaeva, Nadejda;
- Leibel, Sandra L;
- Bray, William;
- McMillan, Rachel E;
- Freshman, Jonathan E;
- Garretson, Aaron F;
- McVicar, Rachael N;
- Rana, Tariq;
- Zhang, Xing-Quan;
- Murphy, Joyce A;
- Schooley, Robert T;
- Hostetler, Karl Y
Early antiviral treatments, including intravenous remdesivir (RDV), reduce hospitalization and severe disease caused by COVID-19. An orally bioavailable RDV analog may facilitate earlier treatment of non-hospitalized COVID-19 patients. Here we describe the synthesis and evaluation of alkyl glyceryl ether phosphodiesters of GS-441524 (RVn), lysophospholipid analogs which allow for oral bioavailability and stability in plasma. Oral treatment of SARS-CoV-2-infected BALB/c mice with 1-O-octadecyl-2-O-benzyl-sn-glyceryl-3-phospho-RVn (60 mg/kg orally, once daily for 5 days starting 12h after infection) reduced lung viral load by 1.5 log10 units versus vehicle at day 2 and to below the limit of detection at day 5. Structure/activity evaluation of additional analogs that have hydrophobic ethers at the sn-2 of glycerol revealed improved in vitro antiviral activity by introduction of a 3-fluoro-4-methoxy-substituted benzyl or a 3- or 4-cyano-substituted benzyl. Collectively, our data support the development of RVn phospholipid prodrugs as oral antiviral agents for prevention and treatment of SARS-CoV-2 infections.