Intranasal fusion inhibitory lipopeptide prevents direct-contact SARS-CoV-2 transmission in ferrets

de Vries, Rory D.; Schmitz, Katharina S.; Bovier, Francesca T.; Predella, Camilla; Khao, Jonathan; Noack, Danny; Haagmans, Bart L.; Herfst, Sander; Stearns, Kyle N.; Drew-Bear, Jennifer; Biswas, Sudipta; Rockx, Barry; McGill, Gaël; Dorrello, N. Valerio; Gellman, Samuel H.; Alabi, Christopher A.; de Swart, Rik L.; Moscona, Anne; Porotto, Matteo

Containment of the COVID-19 pandemic requires reducing viral transmission. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is initiated by membrane fusion between the viral and host cell membranes, which is mediated by the viral spike protein. We have designed lipopeptide fusion inhibitors that block this critical first step of infection and, on the basis of in vitro efficacy and in vivo biodistribution, selected a dimeric form for evaluation in an animal model. Daily intranasal administration to ferrets completely prevented SARS-CoV-2 direct-contact transmission during 24-hour cohousing with infected animals, under stringent conditions that resulted in infection of 100% of untreated animals. These lipopeptides are highly stable and thus may readily translate into safe and effective intranasal prophylaxis to reduce transmission of SARS-CoV-2.