Superinfection by Trichomonas, a Second Reason to Add Metronidazole to COVID-19 Treatment; a Letter to Editor

Abstract

Dear Editor, All countries are struggling against the COVID-19 pandemic. One million deaths have been recorded. Acute respiratory distress syndrome (ARDS) is the major complication. No antiviral therapy has been shown to be clearly effective for reducing the rate of mortality in published randomised controlled trials. In an article published in the last issue of Archives of Academic Emergency Medicine, metronidazole is suggested to be tested in clinical trials (1). In vitro and in vivo studies have revealed that metronidazole could decrease the levels of several cytokines. It could also decrease neutrophil-generated reactive oxygen species, and thus could counteract majority of the immunopathological manifestations of the COVID-19 infection. Metronidazole could be included in clinical trials for another reason. More than ten years ago we observed that lungs of patients diseased from ARDS, show superimposed infection by trichomonads (2).

Keywords

• COVID-19, metronidazole, Respiratory Distress Syndrome, SARS-CoV-2, trichomonas infections