Discussion
diabetes mellitus, hypertension, pneumonia, Hypertension
PNEUMONIA, DISEASE, DIABETES MELLITUS, HYPERTENSION, HYPERTENSION
In the present study, the administration of low-dose demeclocycline for patients with mild-to-moderate COVID-19 was well tolerated and demonstrated potential in mitigating the exacerbation of COVID-19. The number of CD4Patients with mild-to-moderate COVID-19 were recruited in the present study. Immunological responses varied based on the severity of the disease. In the RECOVERY trial, no clear benefit of the dexamethasone treatment was observed among patients with COVID-19 who did not require oxygen support. However, the mortality rate was lower among patients receiving oxygen support who were administered dexamethasone than in the group receiving standard careIn the present study, a significant increase was observed in the population of CD4A plethora of immunomodulatory agents, such as dexamethasone, balicitinib, tocilizumab, and sarilumab, are utilized to treat patients with severe COVID-19. However, there are currently no therapeutic agents that have been specifically developed to support antiviral T cell responses in patients with early and mild COVID-19. The findings of our previous preclinical studies demonstrated that tetracyclines enhanced antigen-specific T cell responsesThe most frequent coexisting conditions in the present study were hypertension (20.0%) and diabetes mellitus (20.0%). Patients with hypertension were 2/7 (28.6%) in the control group and 2/7 (28.6%) in the demeclocycline 150 daily group. Patients with diabetes mellitus were also 2/7 (28.6%) in the control group and 2/7 (28.6%) in the demeclocycline 150 daily group. Hypertension and diabetes mellitus were reported to be at increased risk of developing severe COVID-19The present study had a number of limitations that need to be addressed. We did not conduct an analysis of SARS-CoV-2-specific T cells, which is crucial for understanding the immunological response to SARS-CoV-2 in patients with COVID-19. Furthermore, due to the small cohort size, it was challenging to evaluate clinical responses to the demeclocycline treatment. During the course of this clinical study, we encountered significant difficulties in both patient enrollment and study treatment completion. To minimize the effects of T cell responses, patients who had been vaccinated against COVID-19 were excluded from the study, and the concurrent use of corticosteroids, including dexamethasone, was prohibited during study treatment. Since the majority of Japanese citizens had rapidly received COVID-19 vaccines, there were a limited number of eligible COVID-19 patients who had not been vaccinated. Furthermore, all of the COVID-19 patients enrolled in this study were diagnosed with pneumonia via chest imaging and were generally indicated for dexamethasone treatments when demeclocycline treatments were terminated. We estimated that 8 patients were needed in each three groups, and actually, a total of 23 patients were randomized for the present study. However, the discontinuation of the study treatment, attributed to the administration of dexamethasone, resulted in a reduction in the cohort of patients assessed for T cell responses. Contrary to our hypothesis of CD8In summary, the present study suggests that patients with mild-to-moderate COVID-19 treated with low-dose demeclocycline exhibited T cell responses that were favorable for recovery from COVID-19. However, further studies with larger sample sizes are needed to confirm and expand upon these results.