Doxycycline: a new treatment option for COVID-19
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Doxycycline is a broad-spectrum antimicrobial that targets bacterial protein synthesis and ribosomes. Many reviews discussed the antiviral role of doxycycline on viruses dengue virus (DNV), vesicular stomatitis virus (VSV), and chikungunya virus (CHIKV). Doxycycline can achieve its antiviral action through many mechanisms; interference with viral adsorption as in DNV and CHIKV or Inhibition of replication as in can inhibit DNV and CHIKV proteases; these proteases are involved in the cleavage of viral polyproteins in a close manner to SARS-CoV-2 replication process.

Doxycycline has also an anti-inflammatory activity which is achieved through modulation of the expression of interleukins 6 and 8, and TNF-alpha. It also inhibits the migration of neutrophils to the lungs in mice exposed to intratracheal lipopolysaccharide. Based on previous data, doxycycline could be beneficial in management of SARS-CoV2 through inhibiting viral replication and improving disease outcome through its anti-inflammatory effect.

A recent study found that doxycycline has an in-vitro effect against SARS-CoV2. It can inhibit SARS-CoV2 replication in a concentration-dependent manner. The EC50 of doxycycline against SARS-CoV-2 indicates weak-moderate antiviral effect so it can't be used as a monotherapy to COVID-19. It is recommended to add hydroxychloroquine to doxycycline for better results. This combined regimen is a known treatment for Coxiella burnetii. It has a good safety profile; therefore, it could be a good substitution to azithromycin and hydroxychloroquine regimen for COVID-19 which may induce cardiovascular mortality due to synergistic effects on QT length.

In conclusion, doxycycline is a potent antimicrobial with both antiviral and anti-inflammatory activities. Combined therapy with hydroxychloroquine could be a safe and effective treatment of COVID-19.

Source: https://www.tandfonline.com/doi/full/10.1080/20905068.2020.1790957
Dr. M●●●●●●d I●●●●●l H●●●●n M●●●●●●a and 58 others like this47 shares
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