Tetracycline and viruses: a possible treatment for COVID-19?

Mosquera-Sulbarán, Jesús; Hernández–Fonseca, Hugo

doi:10.1007/s00705-020-04860-8

Cited by 42 publications

(35 citation statements)

References 72 publications

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“…Since it is difficult to predict the progression of SARS-CoV-2 infection, it is reasonable to adopt measures to inhibit the virus to prevent severe illness. Antiviral treatment at the onset of SARS-CoV-2 infection may be important for preventing severe disease in elderly patients, patients at high risk, and in the general population to allow a more effective response by the immune system [105].…”

Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 infection represents a high risk for the elderly: analysis of pathogenesis

2021

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As people get older, age-related alterations occur that lead to increased susceptibility to disease. In the current COVID-19 pandemic, older people are particularly susceptible to a SARS-CoV-2 infection developing into severe disease. The objective of this review was to examine the literature regarding factors that may explain the tendency of this population to develop severe COVID-19. Research articles considered in this review were searched for in EMBASE, PubMed, and Web of Science from December 2019 to December 2020. Citations were screened by two independent reviewers. Studies of the immune system in older individuals found alterations in both the adaptive and innate immune systems. The adaptive system is depressed in its functions, and the innate system is in a pro-inflammatory state that can lead to chronic disease. This proinflammatory state may be related to a severe course of disease in COVID-19. This review shows that the level of evidence supporting an association between immune alterations in the elderly and susceptibly to severe progression of SARS-CoV-2 infection is generally consistent. Preventive measures such as early antiviral treatment are of key importance for prevention of severe progression of COVID19. SARS-CoV-2 infection and pathogenesis Regarding the immunopathogenesis of COVID-19, SARS-CoV-2 uses the renin-angiotensin system (RAS) to enter, replicate, and produce damage in the cell. An important step in SARS-CoV-2 infection is the binding of the viral S protein to its receptor ACE2, a RAS component [5].

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Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 infection represents a high risk for the elderly: analysis of pathogenesis

2021

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“…It has been suggested that doxycycline may have beneficial effects for people affected by the newly emerged coronavirus disease 2019 (COVID19) due to its antiviral and anti-inflammatory properties [ 52 , 53 ]. The latter seem particularly relevant, as dysregulation of the innate immune responses and the cytokine storm have been associated with severe COVID19 cases [ 54 ].…”

Section: Discussionmentioning

confidence: 99%

In Vitro Effects of Doxycycline on Replication of Feline Coronavirus

Dunowska

Ghosh

2021

Pathogens

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Feline infectious peritonitis (FIP) is a sporadic fatal disease of cats caused by a virulent variant of feline coronavirus (FCoV), referred to as FIP virus (FIPV). Treatment options are limited, and most of the affected cats die or are euthanized. Anecdotally, doxycycline has been used to treat FIP-affected cats, but there are currently no data to support or discourage such treatment. The aim of this study was to establish whether doxycycline inhibits replication of FIPV in vitro. The virus was cultured in Crandell-Rees feline kidney cells with various concentrations of doxycycline (0 to 50 µg/mL). The level of FIPV in cultures was determined by virus titration and FCoV-specific reverse-transcription quantitative PCR. Cell viability was also monitored. There was no difference in the level of infectious virus or viral RNA between doxycycline-treated and untreated cultures at 3, 12- and 18-hours post-infection. However, at 24 h, the growth of FIPV was inhibited by approximately two logs in cultures with >10 µg/mL doxycycline. This inhibition was dose-dependent, with inhibitory concentration 50% (IC50) 4.1 µg/mL and IC90 5.4 µg/mL. Our data suggest that doxycycline has some inhibitory effect on FIPV replication in vitro, which supports future clinical trials of its use for the treatment of FIP-affected cats.

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“…However, based on the reporting and clinical experience, the early therapeutics that we advocate for such as HCQ, ivermectin, and doxycycline etc. 12,17, 18, 38, 39 ) may potentially function by working to inhibit viral replication while also dampening the host innate immune response thereby reducing oxidative stress, matrix-metalloproteinase-mediated inflammation/tissue damage, as well as the production of a wider array of inflammatory cytokines. In the meantime then and given the dearth of such randomized evidence that would provide clarification, and given the present emergency crisis, the observational non-randomized data we reviewed which we judged as acceptable to informing this report (and in line with expert arguments for observational study evidence use especially when RCT evidence is not available or is in many cases, of poor methodological quality), 43 suggest a treatment mandate is present and should replace therapeutic nihilism for nursing home residents with acute COVID-19.…”

Section: Discussionmentioning

confidence: 99%

Early Multidrug Outpatient Treatment of SARS-CoV-2 Infection (COVID-19) and Reduced Mortality Among Nursing Home Residents

Alexander

Armstrong²,

Fareed

et al. 2021

Preprint

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The outbreak of COVID-19 from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread all over the world with tremendous morbidity and mortality in the elderly. In-hospital treatment addresses the multifaceted nature of the illness including viral replication, cytokine storm, and endothelial injury with thrombosis. We identified nine reports of early treatment outcomes in COVID-19 nursing home patients. Multi-drug therapy including hydroxychloroquine with one or more anti-infectives, corticosteroids, and antithrombotic agents can be extended to seniors in the nursing home setting without hospitalization. Data from nine studies found multidrug regimens relying on the use of hydroxychloroquine as well as other agents including doxycycline were associated with a statistically significant and >60% reductions in mortality. Going forward, we theorize and based on the evidence, that early empiric treatment for the elderly with COVID-19 in the nursing home setting (or similar congregated settings with elderly residents/patients) has a genuine probability of success and acceptable safety. This group remains our highest at-risk group and warrants acute treatment focus that will prevent the development and/or worsening of problems associated with COVID-19, most particularly isolation, hospitalization, and death. In fact, with the rapidity and severity of SARS-CoV-2 outbreaks in nursing homes, in-center treatment of patients with acute COVID-19 is possibly the most rational and importantly feasible strategy to reduce the risks of hospitalization and death. If the approach remains ‘wait-and-see’ and elderly high-risk patients in such congregated nursing room type settings are allowed to worsen with no early treatment, they may be too sick and fragile to benefit from in-hospital therapeutics and are at risk for pulmonary failure, life-ending micro-thrombi of the lungs, kidneys etc. We put forth the notion that the most important factor in this regard, is making available early therapeutic intervention as described here. These drugs include and under supervision by skilled doctors, combination/sequenced ivermectin, hydroxychloroquine, colchicine, azithromycin, doxycycline, bromhexine hydrochloride, and favipiravir (outside the US), along with inhaled steroids such as budesonide and oral steroids including dexamethasone and prednisone, and anti-thrombotic anti-clotting drugs such as heparin). As the clinical trials data on treatments for COVID-19 mature, this early treatment therapeutic option deserves serious, urgent, and sober consideration by the medical establishment and respective decision-makers.

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Tetracycline and viruses: a possible treatment for COVID-19?

Cited by 42 publications

References 72 publications

SARS-CoV-2 infection represents a high risk for the elderly: analysis of pathogenesis

SARS-CoV-2 infection represents a high risk for the elderly: analysis of pathogenesis

In Vitro Effects of Doxycycline on Replication of Feline Coronavirus

Early Multidrug Outpatient Treatment of SARS-CoV-2 Infection (COVID-19) and Reduced Mortality Among Nursing Home Residents

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