Repurposing low-dose naltrexone for the prevention and treatment of immunothrombosis in COVID-19

Bertram Pitt, Ashley M. Tate, David Gluck, Robert S. Rosenson, Sascha N. Goonewardena

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Coronavirus disease 2019 (COVID-19) is characterized by striking dysregulation of the immune system, with evidence of hyperinflammation, an impaired induction of interferons, and delayed adaptive immune responses. In addition to dysfunctional immune responses, thrombosis is a hallmark of severe COVID-19. Because traditional anticoagulation strategies are associated with increased bleeding, novel strategies that address both the immune and thrombotic dysfunction associated with COVID-19 would be of tremendous benefit. In this commentary, we discuss the unique properties of low dose naltrexone (LDN) which could be leveraged to reduce the immune-mediated thrombotic complications in COVID-19. Mechanistically, LDN can blunt innate immune responses and Toll-like receptor (TLR) signaling, reducing interleukin1 (IL-1), tumor necrosis factor-alpha (TNF-α), and interferon (IFN) levels. Because of the immune-mediated thrombotic mechanisms that underlie COVID-19, we hypothesize that the immune-modulating and known pharmacologic properties of LDN could be leveraged as a novel therapeutic strategy in COVID-19.

Original languageEnglish
Pages (from-to)402-405
Number of pages4
JournalEuropean Heart Journal - Cardiovascular Pharmacotherapy
Issue number4
StatePublished - 1 Jul 2022


  • COVID-19
  • Naltrexone
  • biomarkers
  • inflammation
  • thrombosis


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