Tetracycline antibiotics mainly Doxycycline continues to remain a promising and potentially alternative offering rational and safe management of High-Risk COVID-19 patients. Due to the dual properties of this antibiotic (antiviral and anti-inflammatory property) it may attenuate the immune responses against viral infections. It works on multiple pathways regulating viral replication.
The major pathophysiology of the drug is inhibition metalloproteinases (MMPs), majorly MMP-9, which is likely critical for the initial interaction of the virus into the host cell and inhibition of interleukin (IL)-6. IL-6 and MMPs are key regulators of the ‘cytokine storm’ that leads to severe viral pneumonitis. A very recently published retrospective study assessed the clinical outcomes in high-risk COVID patients with moderate to severe symptoms after early intervention with Doxycycline.
The study included 89 high-risk patients diagnosed with COVID-19. Majority of them had co-morbidities such as hypertension, diabetes, coronary artery disease (CAD), congestive heart, failure and obesity.
These patients diagnosed with COVID-19 were given Doxycycline 100 mg orally or intravenously for 7 days along with the regular standard of care. The results were indicative of significantly improved clinical outcomes. The study concludes that early administration of Doxycycline in high-risk COVID patients with moderate to severe infection in non-hospital settings, such as long-term care facilities (LTCFs), led to early clinical recovery, reduced hospitalization, and mortality.
Doxycycline is also considered to be cardioprotective along with its anti-inflammatory and immunomodulatory properties.
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