{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T18:24:47Z","timestamp":1785435887476,"version":"3.56.0"},"reference-count":76,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:00:00Z","timestamp":1776643200000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Immunity Inflam &amp;amp; Disease"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Despite extensive efforts to identify effective treatments for COVID\u201019, preventive strategies remain essential. Bromhexine hydrochloride (BRH), an over\u2010the\u2010counter mucolytic with potential TMPRSS2 inhibition, may reduce viral entry and thus serve as a prophylactic agent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective questionnaire\u2010based study included 125 individuals reporting prophylactic BRH use. Demographic and clinical data were collected. COVID\u201019 infection rates before and after BRH use were compared. Subgroup analyses were performed by vaccination status, prior infection, and duration of prophylaxis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Participants had a mean age of 56.5 years and a mean BMI of 25.6; 20% were vaccinated. Prior to BRH use, 62.4% reported COVID\u201019 infection, compared to 11.2% after prophylaxis (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). Significant reductions were observed in both vaccinated (48.1% vs. 3.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) and unvaccinated individuals (66.3% vs. 13.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). Prior infection did not significantly influence outcomes (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.9248). Longer BRH use was associated with lower reinfection rates, decreasing from 33.3% (\u2264\u200910 days) to 2.6% (\u2265\u200930 days) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>BRH prophylaxis was associated with reduced reported COVID\u201019 infection rates, independent of vaccination or prior infection, with greater benefit observed with longer use. Prospective controlled studies are required to confirm these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/iid3.70438","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T06:41:34Z","timestamp":1776753694000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["COVID\u201019 Prophylactic Effect of Bromhexine Hydrochloride"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7528-590X","authenticated-orcid":false,"given":"Vanyo","family":"Mitev","sequence":"first","affiliation":[{"name":"Research Institute of Innovative Medical Science, Medical University\u2010Sofia Sofia Bulgaria"},{"name":"Department of Medical Chemistry and Biochemistry, Medical Faculty Medical University\u2010Sofia Sofia Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2511-7016","authenticated-orcid":false,"given":"Tsanko","family":"Mondeshki","sequence":"additional","affiliation":[{"name":"Department of Propaedeutics of Internal Diseases University Hospital Alexandrovska, Medical University\u2010Sofia Sofia Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8555-9812","authenticated-orcid":false,"given":"Ani","family":"Miteva","sequence":"additional","affiliation":[{"name":"Department of Bioethics Faculty of Public Health, Medical University\u2010Sofia Sofia Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3961-7556","authenticated-orcid":false,"given":"Konstantin","family":"Tachkov","sequence":"additional","affiliation":[{"name":"Department of Social Pharmacy and Pharmaco\u2010economics, Faculty of Pharmacy Medical University\u2010Sofia Sofia Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8649-2051","authenticated-orcid":false,"given":"Violeta","family":"Dimitrova","sequence":"additional","affiliation":[{"name":"Department of Medical Chemistry and Biochemistry, Medical Faculty Medical University\u2010Sofia Sofia Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,20]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.51684\/FIRS.133775"},{"key":"e_1_2_11_3_1","article-title":"The Rise and Fall of Paxlovid\u2014HIV and ID Observations","author":"Sax P.","year":"2024","journal-title":"NEJM Journal Watch"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.3897\/pharmacia.70.e112550"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/jpm14070756"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.01518"},{"key":"e_1_2_11_7_1","doi-asserted-by":"crossref","first-page":"106","DOI":"10.9734\/bpi\/codhr\/v10\/5310A","article-title":"Colchicine, Bromhexine, and Hymecromone as Part of COVID19 Treatment \u2010 Cold, Warm, Hot","volume":"10","author":"Mitev V.","year":"2023","journal-title":"Current Overview on Disease and Health Research. 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