Repurposing Methylene Blue for the Management of COVID-19: Prospects, Paradox, and Perspective

ABSTRACT

COVID-19 onslaught has led to widespread morbidity and mortality globally. Another major concern, especially in developing countries like India, has been the development of fungal superinfection and colonization of other pathogens in hospitalized COVID-19 patients. Even though an armamentarium of repurposed, antiviral, anticytokine, and antifungal drugs is available to manage the disease progression, no single drug and/or therapy has provided positive clinical outcomes with efficacy and affordability. Therefore, it is imperative to explore innovative approaches for standalone treatment and/or adjunct therapeutic regimes based on our current understanding of disease prognosis. Low-income and emerging economies have less resources to protect themselves against the COVID-19-induced health and economic crisis. With the continuously evolving nature of coronavirus, a cost-effective strain independent mechanism that could be delivered easily even in a nonhealthcare setting is an urgent need of the hour. Methylene blue appears an apt candidate as it is an FDA-approved safe drug that is economically viable and easily available. Since MB has a long-standing history of being used in clinical setup for diverse medical applications and possesses intrinsic anti-inflammatory, anticytokine, and antifungal properties, this study analyzes prospects of its use in the management of COVID-19. Paradox and prospects of MB applications for the management of COVID-19, with or without fungal superinfections, are also discussed. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023.