The Application of a Reduced Dye Used in Orthopedics as a Novel Treatment against Coronavirus (COVID-19): A Suggested Therapeutic Protocol

The severe acute respiratory syndrome caused by COVID-19 is now a global catastrophic event. Currently thereis no approved drug or vaccine for the disease. Methylene blue (MB, oxidized form, blue color) has been used inmany different areas of clinical medicine, ranging from malaria to orthopedics. Leucomethylene Blue (reduced formof MB, colorless) may be applied for the treatment of COVID-19 according to the scientific evidences. In severepatients, there is a cytokine storm (hyperinflammation) and high oxidative stress (OS). Inflammation and OS hasa mutual correlation and exacerbate each other. In human body, MB first induces OS through absorbing electron(like a free radical) from other molecules, if the body could counteract to this OS, then reduced MB decreasesOS through other mechanisms. Reduced MB could prevent inflammation, propagation of the virus RNA, and alsoimproves hypoxia through reducing methemoglobin. Therefore, to avoid the increment of OS, we suggest usingLeucomethylene Blue through the following protocol: The IV cocktail contains 50 mg MB (1mg/kg, 50-kg weight),1000-2000 mg vitamin C, 500-1000 mg N-Acetylcysteine (or glutathione or cysteine or α-lipoic acid) and 10-20 grurea (optional) in 100 ml dextrose 5%. Before the injection, the cocktail should be kept in a dark place for 1-2 hourto become fade or colorless.Level of evidence: V