COVID-19 prophylaxis with doxycycline and zinc in health care workers: a prospective, randomized, double-blind clinical trial

Stambouli, Nejla; Driss, Adel; Gargouri, Faten; Bahrini, Khadija; Arfaoui, Bilel; Abid, R.; Taamallah, Karima; Hannachi, Souha; Boughariou, Sana; Rebai, Aicha; Naas, Imen; Ghanem, Mohamed; Ammar, Hassib; Aïchaouia, C.; Harrathi, Asma; Yousfi, M.; Battikh, R.; Moussa, Mohamed Ben; Razgallah, Rabie; Ferjani, Mustapha; Gharsallah, Hédi

doi:10.1016/j.ijid.2022.06.016

Cited by 14 publications

(11 citation statements)

References 26 publications

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“…With moderate quality of evidence, disulfiram, 24 carvedilol, 25 beta-blocker, 26 bamlanivimab, 27 warfarin 21 , and doxycycline with or without zinc 28 were associated with significantly lower risk of SARS-CoV-2 infection, while the effects of insulin, 29 oral anticoagulant 29 , and famotidine 21 on SARS-CoV-2 infection were not favourable. Regarding prognostic outcomes, warfarin showed significant reduction in hospitalisation and death from COVID-19, 21 while CCB 26 and aspirin 30 increased the risk of serious illness and hospitalisation, respectively (see details in online supplemental table S3 ).…”

Section: Resultsmentioning

confidence: 99%

Repurposed drug studies on the primary prevention of SARS-CoV-2 infection during the pandemic: systematic review and meta-analysis

Zhou,

Verweij,

Bijlsma

et al. 2023

BMJ Open Resp Res

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ObjectiveCurrent evidence on the effectiveness of SARS-CoV-2 prophylaxis is inconclusive. We aimed to systematically evaluate published studies on repurposed drugs for the prevention of laboratory-confirmed SARS-CoV-2 infection and/or COVID-19 among healthy adults.DesignSystematic review.EligibilityQuantitative experimental and observational intervention studies that evaluated the effectiveness of repurposed drugs for the primary prevention of SARS-CoV-2 infection and/or COVID-19 disease.Data sourcePubMed and Embase (1 January 2020–28 September 2022).Risk of biasCochrane Risk of Bias 2.0 and Risk of Bias in Non-Randomised Studies of Interventions tools were applied to assess the quality of studies.Data analysisMeta-analyses for each eligible drug were performed if ≥2 similar study designs were available.ResultsIn all, 65 (25 trials, 40 observational) and 29 publications were eligible for review and meta-analyses, respectively. Most studies pertained to hydroxychloroquine (32), ACE inhibitor (ACEi) or angiotensin receptor blocker (ARB) (11), statin (8), and ivermectin (8). In trials, hydroxychloroquine prophylaxis reduced laboratory-confirmed SARS-CoV-2 infection (risk ratio: 0.82 (95% CI 0.74 to 0.90), I2=48%), a result largely driven by one clinical trial (weight: 60.5%). Such beneficial effects were not observed in observational studies, nor for prognostic clinical outcomes. Ivermectin did not significantly reduce the risk of SARS-CoV-2 infection (RR: 0.35 (95% CI 0.10 to 1.26), I2=96%) and findings for clinical outcomes were inconsistent. Neither ACEi or ARB were beneficial in reducing SARS-CoV-2 infection. Most of the evidence from clinical trials was of moderate quality and of lower quality in observational studies.ConclusionsResults from our analysis are insufficient to support an evidence-based repurposed drug policy for SARS-CoV-2 prophylaxis because of inconsistency. In the view of scarce supportive evidence on repurposing drugs for COVID-19, alternative strategies such as immunisation of vulnerable people are warranted to prevent the future waves of infection.PROSPERO registration numberCRD42021292797.

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Section: Resultsmentioning

confidence: 99%

Repurposed drug studies on the primary prevention of SARS-CoV-2 infection during the pandemic: systematic review and meta-analysis

Zhou,

Verweij,

Bijlsma

et al. 2023

BMJ Open Resp Res

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“…Evidence from previous trials regarding the effect of zinc on COVID-19 risk and outcomes is more limited [ 27 , 36 , 37 , [58] , [59] , [60] , [61] ]. Although all studies identified here examined daily or twice-daily supplementation, they differed with respect to the dose (range: 15–80 mg) and duration (range: 5 d to 6 wk) of zinc administered and outcomes studied [ 27 , 36 , 37 , [58] , [59] , [60] , [61] ]. None of the identified studies exclusively enrolled populations with low baseline zinc concentrations [ 27 , 36 , 37 , [58] , [59] , [60] , [61] ].…”

Section: Discussionmentioning

confidence: 99%

Vitamin D and Zinc Supplementation to Improve Treatment Outcomes among COVID-19 Patients in India: Results from a Double-Blind Randomized Placebo-Controlled Trial

Partap

Sharma

Marathe

et al. 2023

Current Developments in Nutrition

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“…The combination of doxycycline and zinc had a protective effect in patients with SARS-CoV-2 infection ( 103 ). High doses of zinc gluconate, ascorbic acid, or a combination of zinc gluconate and ascorbic acid did not significantly shorten the duration of symptoms associated with the virus compared with the control group ( 104 ).…”

Section: Methodsmentioning

confidence: 99%

Role of micronutrients in the modulation of immune system and platelet activating factor in patients with COVID-19; a narrative review

Doaei,

Mardi,

Zare

2023

Front. Nutr.

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BackgroundDietary micronutrients may play important roles in the improvement of the immune responses against SARS-CoV-2. This study aimed to assess the effect of micronutrients on platelet activating factor (PAF) and immunity with a special focus on the coronavirus disease 2019 (COVID-19).MethodsAll paper published in English on the effects of micronutrients including fat soluble vitamins, water soluble vitamins, and minerals on PAF, immunity, and COVID-19 were collected from online valid databases.ResultsVitamin A may modulate the expression of PAF-receptor gene in patients with COVID-19. Vitamin D may modulate inflammatory response through influencing PAF pathway. Vitamin E may improve COVID-19 related heart injuries by exert anti-PAF activities. Vitamin C status may have PAF related anti-inflammatory and micro-thrombotic effects in SARS-CoV-2 patients. Furthermore, some trace elements such as copper, selenium, and iron may have key roles in strengthens immunity by inactivate PAF acetyl hydrolase.ConclusionThis narrative review study highlighted the importance of micronutrients in the improvement of immune function through modulation of PAF in patients with COVID-19. Further longitudinal studies are warranted.

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COVID-19 prophylaxis with doxycycline and zinc in health care workers: a prospective, randomized, double-blind clinical trial

Cited by 14 publications

References 26 publications

Repurposed drug studies on the primary prevention of SARS-CoV-2 infection during the pandemic: systematic review and meta-analysis

Repurposed drug studies on the primary prevention of SARS-CoV-2 infection during the pandemic: systematic review and meta-analysis

Vitamin D and Zinc Supplementation to Improve Treatment Outcomes among COVID-19 Patients in India: Results from a Double-Blind Randomized Placebo-Controlled Trial

Role of micronutrients in the modulation of immune system and platelet activating factor in patients with COVID-19; a narrative review

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