Expert Rev Clin Pharmacol. 2021 Feb 15. doi: 10.1080/17512433.2021.1888714. Online ahead of print.
Introduction: The global coronavirus disease-2019 (COVID-19) pandemic has posed a critical challenge to the research community as well as to the healthcare systems. Severe COVID-19 patients are at a higher risk of developing serious complications and mortality. There is a dire need for safe and effective pharmacotherapy for addressing unmet needs of patients with severe COVID-19 infection. Concomitant use of dexamethasone and tetracyclines, by virtue of their immunomodulatory and other relevant pharmacological properties, offers a potential strategy for synergy aimed at improving clinical outcomes. Areas Covered: Here we review the potential benefits of combining dexamethasone and tetracyclines (minocycline or doxycycline) for the management of severe COVID-19 patients. We have critically examined the evidence obtained from in silico, experimental, and clinical research. We have also discussed the plausible mechanisms, advantages and drawbacks of this proposed combination therapy for managing severe COVID-19. Expert Opinion: The concomitant use of dexamethasone and one of the tetracyclines among severe COVID-19 patients, offers several advantages in terms of additive immunomodulatory effects, cost-effectiveness, wide-availability, and well-known pharmacological properties including adverse-effect profile as well as contraindications. There is an urgent need to facilitate pilot studies followed by well-designed and adequately powered multicentric clinical trials to generate conclusive evidence related to utility of this approach.