We would like to draw attention to the potential of immunomodulatory
tetracyclines for severe COVID-19. The COVID-19 pandemic is having a
devastating impact on developing countries. A successful approach to
manage the scarcity of cost-effective therapies worldwide is drug
repurposing. Predictions of direct anti-viral activity of tetracyclines
against SARS-CoV2 have been confirmed experimentally. Furthermore, their
effectiveness in experimental ARDS has been proven extensively,
counteracting the overt inflammatory reaction and fibrosis sequelae due
to a synergic combination of pharmacological activities. Finally, a few
clinical reports have confirmed their potentiall in COVID-19 patients,
encouraging the development of this novel indication. We believe that
the benefits of their multi-target pharmacology and their safety profile
place immunomodulatory tetracyclines as gold repurposing candidates for
COVID-19.