Minocycline for COVID-19

Introduction: Minocycline a semi-synthetic tetracycline is a potential therapeutic option for COVID-19 because of its anti-inflammatory and immunomodulatory effects. Moreover, its antioxidant, antiviral, and antiapoptotic effects have been proven. In this study, the efficacy of minocycline in the therapy of COVID-19 patients has been evaluated. Methods: A randomized double-blind placebo-controlled clinical trial was performed in Mashhad, Iran. 40 outpatients were randomized to either the treatment with the minocycline group or the placebo group, in a 1:1 ratio with 20 patients in each group. The Iranian National COVID-19 Therapy Regimen at the time was used in both groups and patients in the treatment group also received oral minocycline 100 mg twice day for 14 days. Patients in both groups were followed on days 3, 7, and 14 after initiating therapy for clinical symptom improvement, improvement of lymphocytes, leukocytes, C-reactive protein (CRP) and SpO2. Results: A total of 40 patients with similar demographic and disease characteristics were enrolled. Results showed that the time interval until clinical symptoms improvement was significantly reduced in the minocycline group (6.85±0.79, day) compared to the placebo (10.95±1.18, day) group (P=0.006). Moreover, the time interval until leukocytes reaching normal limits was significantly reduced in the minocycline group (3.95±0.59, day) compared to the placebo (6.72±1.25, day) group (P=0.046). Conclusion: In this randomized double-blind placebo-controlled study, minocycline (100 mg, BID for 14 days) reduced the duration of clinical symptoms improvement as well as the duration of white blood cell (WBC) normalizing in outpatients of COVID-19 disease.

Since the outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its resultant pneumonia in December 2019, the cumulative number of infected people worldwide has exceeded 670 million, with over 6.8 million deaths. Despite the marketing of multiple series of vaccines and the implementation of strict prevention and control measures in many countries, the spread and prevalence of SARS-CoV-2 have not been completely and effectively controlled. The latest research shows that in addition to angiotensin converting enzyme II (ACE2), dozens of protein molecules, including AXL, can act as host receptors for SARS-CoV-2 infecting human cells, and virus mutation and immune evasion never seem to stop. To sum up, this review summarizes and organizes the latest relevant literature, comprehensively reviews the genome characteristics of SARS-CoV-2 as well as receptor-based pathogenesis (including ACE2 and other new receptors), mutation and immune evasion, vaccine development and other aspects, and proposes a series of prevention and treatment opinions. It is expected to provide a theoretical basis for an in-depth understanding of the pathogenic mechanism of SARS-CoV-2 along with a research basis and new ideas for the diagnosis and classification, of COVID-19-related disease and for drug and vaccine research and development.

IntroductionThe COVID-19 Disease Map project is a large-scale community effort uniting 277 scientists from 130 Institutions around the globe. We use high-quality, mechanistic content describing SARS-CoV-2-host interactions and develop interoperable bioinformatic pipelines for novel target identification and drug repurposing. MethodsExtensive community work allowed an impressive step forward in building interfaces between Systems Biology tools and platforms. Our framework can link biomolecules from omics data analysis and computational modelling to dysregulated pathways in a cell-, tissue- or patient-specific manner. Drug repurposing using text mining and AI-assisted analysis identified potential drugs, chemicals and microRNAs that could target the identified key factors.ResultsResults revealed drugs already tested for anti-COVID-19 efficacy, providing a mechanistic context for their mode of action, and drugs already in clinical trials for treating other diseases, never tested against COVID-19. DiscussionThe key advance is that the proposed framework is versatile and expandable, offering a significant upgrade in the arsenal for virus-host interactions and other complex pathologies.