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Potential new treatment strategies for COVID-19: is there a role for bromhexine as add-on therapy?

Depfenhart et al., Internal and Emergency Medicine, doi:10.1007/s11739-020-02383-3
May 2020  
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Proposal to use bromhexine to inhibit TMPRSS2-specific viral entry for prophylaxis and treatment of COVID-19.
Depfenhart et al., 26 May 2020, peer-reviewed, 5 authors.
This PaperBromhexineAll
Potential new treatment strategies for COVID-19: is there a role for bromhexine as add-on therapy?
Markus Depfenhart, Danielle De Villiers, Gottfried Lemperle, Markus Meyer, Salvatore Di Somma
Internal and Emergency Medicine, doi:10.1007/s11739-020-02383-3
Of huge importance now is to provide a fast, cost-effective, safe, and immediately available pharmaceutical solution to curb the rapid global spread of SARS-CoV-2. Recent publications on SARS-CoV-2 have brought attention to the possible benefit of chloroquine in the treatment of patients infected by SARS-CoV-2. Whether chloroquine can treat SARS-CoV-2 alone and also work as a prophylactic is doubtful. An effective prophylactic medication to prevent viral entry has to contain, at least, either a protease inhibitor or a competitive virus ACE2-binding inhibitor. Using bromhexine at a dosage that selectively inhibits TMPRSS2 and, in so doing, inhibits TMPRSS2-specific viral entry is likely to be effective against SARS-CoV-2. We propose the use of bromhexine as a prophylactic and treatment. We encourage the scientific community to assess bromhexine clinically as a prophylactic and curative treatment. If proven to be effective, this would allow a rapid, accessible, and cost-effective application worldwide.
Author contributions The authors wish it to be known that, in their opinion, the first two authors (MD and DdV) should be regarded as joint first authors. MD contributed to writing the article, literature research, and proposed the drug based on the criteria discussed in the article. DdV contributed to writing the article, literature research, and contributed the illustrations. GL contributed literature research, additional writing, advise, and context. MM contributed literature research, additional writing, advise, and context. SDS contributed literature research, additional writing, advise, and context. Ethical approval No ethics approval is required. Consent to participate This article does not contain any study with humans performed by any of the authors. Consent for publication No informed consent is required. Code availability Not applicable.
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