Utilizing the Crosstalk Among Minocycline, Chicoric Acid, 13-Cis Retinoic Acid(Aerosolized) and Vitamin D as a Potent Quadrate Therapy for treating coinfection with Multidrug-resistant TB and COVID-19 . A double-edged sword Clinical Study

Abstract

Tuberculosis (TB) is a major infectious disease killer globally. It affected 10 million and killed 1.4 million people in 2019 alone. TB is considered a disease caused by a bacterium—Mycobacterium tuberculosis—that usually attacks the lungs, but can attack any part of the body. But TB has a worrisome connection to the novel coronavirus.. Both diseases are airborne and spread when people cough or sneeze. The predicted impact of the COVID-19 pandemic is an additional 190,000 TB deaths in 2020, and it is expected in the next 5 y that there will be up to a 20% increase in the global TB disease burden, stressing the critical need for new safe and effective drugs against Mycobacterium tuberculosis (Mtb). In addition, controlling multidrug-resistant TB (MDR-TB) presents a huge public health challenge. Recently it was showed that hospitalized patients with Tuberculosis are more susceptible to COVID-19 infection and complication. Furthermore, hospitalized patients with MDR-TB are increasingly vulnerable to COVID-19 complications than patients with non-resistant tuberculosis.. For someone with latent TB, contracting COVID-19 could activate the bacterium, potentially leading to an accelerated and more severe form of the disease WHO estimates that these COVID-19 related disruptions in access to TB care could cause an additional half a million TB deaths. Older age, especially >65 years, may be a risk factor for death from COVID-TB, consistent with previous findings indicating that the mortality rate from COVID-19 increases exponentially with age. Thus, the elderly should be the primary focus of both COVID-19 and COVID-TB mitigation efforts due to its much higher mortality risk in that group. COVID-TB patients had a much higher rate of comorbidities than COVID-19 patients At present, evidence suggests that the main transmission route of both COVID-19 and TB is via respiratory droplets, and their main target are the lungs, which can lead to a worse outcome among COVID-19 and TB coinfection patients (aptly abbreviated COVID-TB). As a result, coinfections with common viral and bacterial (COVID-TB) pathogens among hospitalized patients are a severe concern that will likely worsen patient outcomes and pose a real challenge for treating those patients.ConclusionsNew drug discovery could require several years with no guarantee but repurposing established drugs may be useful to treat confection with COVID-19 and Nonresistant Strains of Mycobacterium tuberculosis: or resistant Strains of Mycobacterium tuberculosis . Here we demonstrate that we could utilize the crosstalk among Chicoric Acid, 13-Cis Retinoic Acid, Minocycline and vitamin D as a novel quadrate therapy against Multidrug-resistant TB and COVID-19 coinfection.