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AIMS Medical Science

2023, Volume 10, Issue 2: 118-129. doi: 10.3934/medsci.2023010
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Hydroxyurea and pyridostigmine repurposed for treating Covid-19 multi-systems dysfunctions

  • 1.
    PhD, Associate Professor & Graduate Program Coordinator, Winston-Salem State University, School of Health Sciences, Winston-Salem, NC 27110, USA
  • 2.
    MD, Internist, Independent, Greensboro, NC 27408, USA
  • 3.
    MD, Internist (Retired), Greensboro, NC 27455, USA
  • 4.
    PharmD, Independent, Greensboro, NC 27406 USA
  • Received: 03 October 2022 Revised: 06 April 2023 Accepted: 23 April 2023 Published: 28 April 2023

  • Early in the COVID-19 pandemic, medical care providers at an acute illness hospital received increasing numbers of post-acute advanced COVID-19 patients from referring hospitals where they were showing no signs of improvement after receiving treatments from standard Emergency Use Authorization (EUA)-type protocols. The care providers turned to repurposing medications to treat these patients and added hydroxyurea, a medication commonly used for treating sickle cell anemia, to the hospital's COVID-19 treatment protocol and began to see notable clinical improvements. As the pandemic continued and new concerns arose concerning COVID-19 complications, those same care providers again turned to repurposing drugs. Focusing on the neuromuscular effects seen in COVID-19 patients, care providers turned to medications used to treat chronic neuromuscular conditions. Post-acute advanced Covid-19 patients initially received an abbreviated course of hydroxyurea followed by titrated doses of pyridostigmine. Positive responses were noted with cognition, diminished oxygen demands, progressive decrease in ventilator support, improved swallowing, and mobility. The authors suggest repurposed drugs could have great utility for treating COVID-19. It is recommended larger, COVID-19 clinical trials be completed to include hydroxyurea and pyridostigmine for validating the outcomes and clinical observations seen in these presented cases.

    Citation: Melissa R. Bowman Foster, Ali Atef Hijazi, Raymond C. Sullivan Jr, Rebecca Opoku. Hydroxyurea and pyridostigmine repurposed for treating Covid-19 multi-systems dysfunctions[J]. AIMS Medical Science, 2023, 10(2): 118-129. doi: 10.3934/medsci.2023010

    Related Papers:

  • Early in the COVID-19 pandemic, medical care providers at an acute illness hospital received increasing numbers of post-acute advanced COVID-19 patients from referring hospitals where they were showing no signs of improvement after receiving treatments from standard Emergency Use Authorization (EUA)-type protocols. The care providers turned to repurposing medications to treat these patients and added hydroxyurea, a medication commonly used for treating sickle cell anemia, to the hospital's COVID-19 treatment protocol and began to see notable clinical improvements. As the pandemic continued and new concerns arose concerning COVID-19 complications, those same care providers again turned to repurposing drugs. Focusing on the neuromuscular effects seen in COVID-19 patients, care providers turned to medications used to treat chronic neuromuscular conditions. Post-acute advanced Covid-19 patients initially received an abbreviated course of hydroxyurea followed by titrated doses of pyridostigmine. Positive responses were noted with cognition, diminished oxygen demands, progressive decrease in ventilator support, improved swallowing, and mobility. The authors suggest repurposed drugs could have great utility for treating COVID-19. It is recommended larger, COVID-19 clinical trials be completed to include hydroxyurea and pyridostigmine for validating the outcomes and clinical observations seen in these presented cases.


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    Acknowledgments


    The authors would like to express immense gratitude to Maryna Skok D. Sci at the Palladin Institute of Biochemistry of the National Academy of Sciences of Ukraine in Kyiv for her invaluable contributions and continued dedication to the field of research. Her extensive research with α7nicotinic acetylcholine receptors have greatly contributed to our appreciation of patient clinical outcomes and given us more validation for continued efforts to share important concepts related to multi systems pathophysiologies with COVID-19.
    The authors would also like to acknowledge Anupama Matcha MD, MPH, Farouque Khan MD, Chun Li NP, Ms. Priya Varghese NP, David Best MD, and Weston Saunders MD for their amazing contribution and dedication to helping critically ill patients with repurposed drugs, which greatly contributed to the possibility of this article.

    Conflict of interest


    The authors declare no conflict of interest.

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