Preprint Hypothesis Version 1 Preserved in Portico This version is not peer-reviewed

Antibiotics Against COVID-19 and Mitochondria? Urgent Thinking Out of the Box

Version 1 : Received: 9 April 2020 / Approved: 16 April 2020 / Online: 16 April 2020 (12:14:30 CEST)

How to cite: Tyszka, J.; Kobos, K.; Tyszka, A. Antibiotics Against COVID-19 and Mitochondria? Urgent Thinking Out of the Box. Preprints 2020, 2020040269. Tyszka, J.; Kobos, K.; Tyszka, A. Antibiotics Against COVID-19 and Mitochondria? Urgent Thinking Out of the Box. Preprints 2020, 2020040269.


Italian, Spanish, French vs German, Austrian or Norwegian COVID-19 tracks? Antibiotics might have a partial impact on COVID-19 death rates in various countries. Our working hypotheses based on recent publications is that that antibiotics may be a major factor that negatively affects patients’ immune system during viral infections. We are all aware that there is no specific and effective medical treatment for COVID-19 so far. However, we know that our immune system is the only efficient weapon that fights against this syndrome right now. In fact, antibiotics are very often prescribed to prevent secondary infections following an antiviral immune response. Various antibiotic therapies have also been commonly applied to support COVID-19 treatments in China and Italy. Unfortunately, the frequent antibiotic off-site targets include mitochondria that are genetically and evolutionary closely linked to bacteria. Mitochondria are multifunctional organelles responsible for bioenergetics in nearly all our cells, acting as signaling hubs in antiviral and antibacterial immune responses. Several studies have demonstrated that mitochondria are vulnerable to antibacterial treatments, interrupting their physiology. Inhibition of these processes by antibiotics might render the immune system less capable of fighting acute COVID-19 viral infections. Some antibiotics, including those prescribed for COVID-19 in Wuhan, have been shown to inhibit the synthesis of mitochondrial DNA. The question is whether antibiotics support such a treatment or weaken patient immune responses in this case. This hypothesis should be evaluated based on comparative clinical data that seem to be unavailable at the moment. Possibly the COVID-19 risk group should be extended to all patients being treated with antibiotics, including those who finished antibiotic therapies days up to several months before SARS-CoV-2 infection. We therefore urge health service response groups to evaluate the impact of antibiotics on COVID-19 recovery vs death retrospective data. We would like to motivate international, national and local health authorities to share available clinical treatment data, discuss and optimize treatment strategies.


COVID-19; SARS-CoV-2; pandemic; antibiotics; immune response; mitochondria; epidemiology; health policy


Chemistry and Materials Science, Theoretical Chemistry

Comments (2)

Comment 1
Received: 22 April 2020
Commenter: Dernis van Eenennaam
The commenter has declared there is no conflict of interests.
Comment: Thank you for posting this article and being able to comment. In my out of the box thinking it is certainly true that antibiotics have a negative influence. In my opinion it has to do with a vacuum created by sterility. A balanced microclimate also has a limiting factor for other viruses and bacteria. Many infections have taken place in hospitals. But this is an environment where a higher hygiene standard prevails as normally.
Because the limiting factor of a microclimate has disappeared, a virus like Covid-19 can explode. That is also the reason that my thinking in treathment is much more focused on how I can enhance the effect of a limiting microclimate. I have gained several practical experiences in the field of veterinary medicine here. Think of probiotics, but not to forget is contamination with viruses and bacteria is a very old method of ensuring maternal immunity.
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Response 1 to Comment 1
Received: 27 April 2020
The commenter has declared there is no conflict of interests.
Comment: Thank you for sharing your comments. We all have to admit that antibiotics often do magic. Nevertheless, we should keep in mind all their side effects.

Yes, sterility is definitely an issue that creates an outbalanced microclimate. Possibly, probiotics might help to keep an optimal balance. It is out of the box thinking in the context of clinical sterility. Such probiotics could help to limit other very serious issues, like antibiotic resistance, sepsis etc. I have no medical background, but as far as I know, probiotics seems to work pretty well in balancing our internal microbiome that also suffers from antibiotics. However, the problem appears, if we want to treat outbalanced mitochondria. There are no “mitochondrial” probiotics that help any more …

On the other hand, there are selected (even antibiotic) treatments that might have less negative impact on mitochondria and bioenergetics. Well, this is my hope from the paleobiological perspective. I think our immune evolutionary tools are still the best! Any medical recommendations would be more than welcome …

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