Methylene blue may have a role in the treatment of COVID-19

Abstract

In this paper, we raise the hypothesis that Methylene Blue may be a treatment option for Corona Virus Disease of 2019 specially when combined with Non Steroid Anti-Inflammatory Drugs. In previous publications including ours, the role of kininogen system has been postulated. A correlation between clinical findings of the disease and this mechanism has been drawn to denote a pivotal role of kininogen-kallikrein system in pathophysiology of the disease. Therein the possible role of Icatibant, Ecallantide and Aprotinin in the treatment of this disease has been raised. Here we want to emphasize on an important post-receptor mechanism of bradykinin that is Nitric Oxide. We came to this aim because we found out how access to these novel treatment nominees may be expensive and unaffordable. For this reason we are focusing on possible role of an old albeit “mysterious” drug namely Methylene Blue. This medication may abort effects of Bradykinin by inhibition of Nitric Oxide synthase inhibitor and promote oxygen saturation while it is inexpensive and ubiquitously accessible. Clinical studies cannot be over emphasized.

Is photodynamic therapy a viable antiviral weapon against COVID-19 in dentistry?

“…14 The distressful symptoms of oral pain, blisters, and vesiculobullous lesions present in few symptomatic oral lesions in COVID-19Àpositive patients are attributed to derangement in the ACE-2 receptor and the subsequently increased bradykinin activity as part of the kininogen-kallikrein system. 13 This could also be the reason for the dilation of blood vessels and swelling in these cases. Furthermore, it is speculated that an immunologic phenomenon known as cytokine storm occurs in COVID-19 as in other viral diseases like influenza.…”

“…1 Additionally, MB without photoactivation has been found to inactivate SARS-CoV-2 in vitro. 13 This makes MB a strong candidate in the management of COVID-19 lesions. Furthermore, MB has been shown to inhibit the SARS-CoV-2 spike protein's protein-protein interaction and its receptor angiotensin-converting enzyme 2 (ACE-2), a critical step.…”

In Vitro Evaluation of the Antiviral Activity of Methylene Blue Alone or in Combination against SARS-CoV-2

“…[ 19 , 20 , 21 , 22 , 23 ]. The repurposed methylene blue could be a potent candidate in the treatment of COVID-19 [ 24 ]. SARS-CoV-2 in plasma or in infected Vero E6 cells was inactivated by photoactivation [ 25 , 26 , 27 ].…”

From quarantine room: Physician perspective

“…Methylene blue inhibit the nitric oxide synthese enzyme and improve the alveolar capillary perfusion. [ 41 ]…”