Sequential doxycycline and colchicine combination therapy in Covid-19: The salutary effects.
Sequential doxycycline and colchicine combination therapy in Covid-19: The salutary effects.
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DOI：
10.1016/j.pupt.2021.102008
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发表时间：
2021-04
影响因子：
3.2
通讯作者：
El-Saber Batiha G
中科院分区：
文献类型：
--
作者：
Al-Kuraishy HM;Al-Gareeb AI;Qusty N;Cruz-Martins N;El-Saber Batiha G
2019冠状病毒病（COVID-19）是由严重急性呼吸道综合征冠状病毒2（SARS-CoV-2）引起的病毒性传染病，实际上被认为是全球大流行病。SARS-CoV-2的切入点是血管紧张素转换酶2（ACE 2）和二肽基肽酶4（DPP 4），它们在肺中高度表达。在其他并发症中，COVID-19导致致命性肺炎、急性肺损伤（ALI）和由于细胞因子风暴（CS）的发展而导致的急性呼吸窘迫综合征（ARDS）。SARS-CoV-2感染的发病机制取决于COVID-19第一阶段病毒清除所需的病毒载量和人类先天/适应性免疫应答。然而，COVID-19第二阶段的过度免疫反应导致免疫过度反应和CS诱导的ALI和ARDS。因此，考虑到这些因素，我们在此报告了一系列5例发生ALI的COVID-19肺炎患者。除支持治疗外，患者在第一周接受多西环素，第二周接受多西环素加秋水仙素。COVID-19肺炎患者接受多西环素和/或秋水仙碱序贯治疗后，患者的疾病严重程度和症状减轻，临床和放射学结局更好。然而，由于这是一个小病例系列报告，因此很坚韧证实这种治疗组合与COVID-19肺炎康复之间的联系。然而，这项研究为大规模前瞻性研究提供了一个合理的依据，以评估多西环素和秋水仙碱对COVID-19严重程度的双重序贯效应。该病例系列表明，秋水仙素：多西环素联合使用与COVID-19肺炎患者的临床、实验室和放射学结局显着改善有关。然而，我们无法从我们的观察中得出任何明确的结论，尽管我们假设这种联合治疗方案可能会减弱和治疗COVID-19。此外，在这方面建议进行前瞻性、随机和对照临床研究。
Coronavirus virus disease 2019 (COVID-19) is a viral infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), actually considered as a global pandemic. The entry-point for SARS-CoV-2 is angiotensin converting enzyme 2 (ACE2) and dipeptidyl peptidase 4 (DPP4), which are highly expressed in the lung. Among other complications, COVID-19leads to fatal pneumonia, acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) due to development of cytokine storm (CS). The pathogenesis of SARS-CoV-2 infection depends on the viral load and human innate/adaptive immune response that are required for viral elimination in the first phase of COVID-19. However, an exaggerated immune response in the second phase of COVID-19 results in immune overreaction and CS-induced ALI and ARDS. Thus, in view of these considerations, we report here a series of five patients with COVID-19 pneumonia who developed ALI. In addition to the supportive therapy, the patients received doxycycline in the first week and doxycycline plus colchicine in the second week. Following sequential therapy with doxycycline and/or colchicine in patients with COVID-19 pneumonia, the patients had reduction of disease severity and symptoms with better clinical and radiological outcomes. However, it is tough to confirm the link between this therapeutic combination and recovery from COVID-19 pneumonia, as it is a small case-series report. Nevertheless, this study gives a rational for large-scale prospective studies to evaluate the dual sequential effect of doxycycline and colchicine on the COVID-19 severity. This case-series illustrated that use of colchicine: doxycycline combination is linked with marked improvements in the clinical, laboratory and radiological outcomes in patients with COVID-19 pneumonia. However, we cannot sketch any definitive conclusion from our observation, despite we hypothesize that this combination therapeutic regimen may attenuate and treat COVID-19. Further, namely prospective, randomized, and controlled clinical studies are recommended in this regard.
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影响因子：
1.4
作者：
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通讯作者：
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影响因子：
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秋水仙碱减少了实验性急性呼吸窘迫综合征中的肺损伤。
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