The potential role of Fluoroquinolones in the management of COVID-19 a rapid review

Damanhouri, Z. A.; Alkreathy, H. M.; Ali, A. S.; Shahid, Karim

COVID-19 is a pandemic viral pneumonia caused by beta-coronavirus SARS-CoV-2. It is associated with many complications including extreme systemic inflammatory response which eventually causes acute respiratory distress syndrome (ARDS), hypercoagulability, cytokine storm, failure of vital organs, and a high incidence of death. Bacterial secondary infection is possibly involved, in such cases, the role of antibiotics is justified. However, some antibiotics may have a role beyond the management of secondary infection. The current review discussed the potential antiviral effects of certain Fluoroquinolones (FQs) against SARS CoV-2 viruses. Several mechanisms such as targeting Main proteases and acting as zinc ionophore are discussed. Also explained their unique features, good access to lung tissues for suppression of inflammatory response via modulation of matrix metallopeptidases (MMPs) are explored. Their role in secondary infections, pharmacokinetics, and safety issues was briefly explored. The promising favorable features of FQs along with their efficacy in the management of secondary infections, highlights the need to consider these important antibiotics for more research as well as clinical trials in the management of COVID-19.