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. 2020 Apr 16:2047487320919233. doi: 10.1177/2047487320919233

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© The European Society of Cardiology 2020

This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.

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Figure 1. — Proposed mechanism of action of amiodarone on coronavirus replication.

Viruses bind to receptors on the plasma membrane and are internalized by endocytosis. Amiodarone accumulates into late endosomes/lysosomes (LE/Lys) and increases the pH of these organelles. Through this mechanism, amiodarone blocks the mixing of viral and endosomal membranes, and then the release of the viral genome into the cytoplasm, and ultimately virus replication. Further inhibitory effects of amiodarone on virus replication cannot be excluded.

ACE2: angiotensin-converting enzyme 2.