The aim of the study is to compare a treatment with doxycycline vs a placebo as soon as the patient is confirmed COVID-19 + and before the onset of oxygen dependence with the aim of reducing or even abolishing the cytokine explosion and thus the evolution towards a serious form of the disease which can lead to death. Three criteria support the rational use of tetrcycline in COVI-19 (1) The coronaviruses is known to bind to metalloproteases (MMPs) of the host, in particular to ensure viral survival. Tetracyclines are known to chelate zinc from MMPs. Their chelating activity may help inhibit COVID19 infection by limiting its ability to replicate in the host. (2) Tetracyclines may also be able to inhibit the replication of positive-polarity single-stranded RNA viruses, such as COVID19 (demonstrated on the dengue virus). (3) In addition, tetracyclines are modulators of innate immunity (anti-inflammatory activity), a property used in the treatment of inflammatory skin diseases for many years. These modulating effects are noted on several targets of innate immunity: They can decrease the expression of NFKB, the release of inflammatory cytokines such as TNF-α, IL-1β and IL-6, inhibit granulomas inflammatory and free radical release. Tetracyclines could therefore participate in limiting the cytokine release induced by COVID19. Their lipophilic nature and their strong pulmonary penetration could allow them to inhibit viral replication.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
comparison of doxycycline 200 mg/day to placebo
Placebo : lactose, 380 mg/gélule
CHU Avicenne - APHP
Bobigny, France
CHU Bordeaux
Bordeaux, France
CHU Caen
Caen, France
CHU Dijon
Dijon, France
CHU Grenoble
Grenoble, France
CHU Nantes
Nantes, France
Percentage of Patients with Clinical Respiratory Aggravation
Percentage of patients with clinical worsening (SaO2 ≤ 93%) after at least 48 hours of treatment
Time frame: after at least 48 hours of treatment
Percentage of patients hospitalized
Percentage of patients hospitalized after at least 48 hours of experimental treatment
Time frame: after at least 48 hours of experimental treatment
Percentage of patients requiring ventilatory assistance
Percentage of patients requiring ventilatory assistance
Time frame: Day 0 to Day 28
Positive SARS-CoV-2 PCR Test
Number of positive SARS-CoV-2 PCR tests on D-1 / D0 and D7 (+/- 2 days)
Time frame: Day -1 or day 0 AND Day 7
Duration of symptoms
Duration of symptoms (fever, painful symptoms: headache, sore throat, dyspnea)
Time frame: Day 0 to Day 28
Duration of hospitalization
Total duration of hospitalization
Time frame: From day 0 until to the end of hospitalization or date of death for any cause, whichever came first, assessed up to 3 months after Day0
Hospitalization intensive care or reanimation
Duration of hospitalization in intensive care or reanimation
Time frame: From day 0 until to the end of hospitalization or date of death for any cause, whichever came first, assessed up to 3 months after Day0
Duration of mechanical ventilatory assistance
Duration of mechanical ventilatory assistance
Time frame: to the end of mechanical ventilatory assistance if any, assessed up to 3 months after Day0
Percentage of deaths related to SARS-CoV-2
Percentage of deaths related to SARS-CoV-2 infection
Time frame: Day 28, or end of hospitalization if any (assessed up to 3 months after Day0)
AE / SAE in both arms
Number of AE / SAE in both arms
Time frame: Day 28, or end of hospitalization if any (assessed up to 3 months after Day0)
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