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The emergence of respiratory viruses has been attracting considerable interest due to their potential to cause pandemics, such as the 1918 Spanish flu, the 2019 Coronavirus disease, and recently the Respiratory syncytial virus (RSV) in pediatric populations. There is a critical need to identify potential agents that can be included as part of the countermeasures to aid in the preparedness for a rapid public health response in case of a pandemic. This study aimed to explore the antiviral potential of sugar alcohols against respiratory viruses with pandemic potential.

Methods: The antiviral activity of three sugar alcohols commonly utilized in the food and pharmaceutical industry, namely sorbitol, erythritol, and xylitol, were evaluated against Influenza (H1N1), RSV (A2), and SARS-CoV-2 (B.1.617.2; Delta) via a highly differentiated, three-dimensional, in vitro model of normal, intact, human-derived tracheal/bronchial epithelial cells. The sugar alcohol solutions were tested at a 5% concentration in duplicate inserts of the three-dimensional tissue models of the human airway.

Results: Antiviral activity was measured in virus yield reduction assays by calculating the log reduction value defined as the average reduction of virus compared to the average virus control on day 3 (Influenza), day (RSV), and day 6 (SARS-CoV-2) after infection. Antiviral agents utilized as comparators were Ribavirin (Influenza, RSV) and Remdesivir (SARS-CoV-2). Erythritol displayed antiviral efficacy against Influenza with a log reduction value of 3.17. RSV was effectively inactivated by both sorbitol and xylitol with 2.49 and 2.65 log reduction values, respectively. All tested sugar alcohols inactivated SARS-CoV-2 Delta with a median log reduction value of 3.50.

Conclusion: The results of this study suggest that alone or in combination, sugar alcohols can inactivate respiratory viruses known to have pandemic potential. Additional research is needed to advance the development of sugar alcohols as chemotherapeutic countermeasures against other pandemic respiratory viruses.