COX2 Inhibition in the Treatment of COVID-19: Review of Literature to Propose Celecoxib Repositioning for Randomized Controlled Studies

Baghaki, Semih; Yalcin, Can Ege; Baghaki, Hayriye Sema; Aydin, Servet Yekta; Daghan, Basak; Yavuz, Ersin

Coronavirus triggered pulmonary and systemic disease, i.e. systemic inflammatory response to virally triggered lung injury, named as COVID-19 and still ongoing discussions on refining immunomodulation in COVID-19 without COX2 inhibition directed us to search the related literature to point out a potential target (COX2) and a weapon (celecoxib). The impression of selectively targeting COX2 and closely related cascades might be worth to try in the treatment of COVID-19 given the substantial amount of data regarding COX2, p38 MAPK, IL-1b, IL-6 and TGF-b are playing pivotal roles in coronavirus related cell death, cytokine storm and pulmonary interstitial fibrosis. Considering lack of definitive treatment and importance of immunomodulation in COVID-19; COX2 inhibition might be a valuable adjunct to still evolving treatment strategies. Celecoxib has credentials to be proposed and evaluated in randomized controlled studies besides being available to be used off label.