ABSTRACT
In the setting of the raging COVID-19 pandemic, the search for innovative therapeutics is desperately sought after. As we learn more about the characteristics and metabolic health of patients and as our understanding of COVID-19 pathophysiology and treatment progresses, so is our understanding of medication effects that might increase disease severity. As of late, ACE inhibitors have been under investigation for a potential increase in illness severity due to ACE2 upregulation. Given our knowledge of other nutrient-pharmaceutical interactions, could the ACE inhibitor impact on COVID be due to something else? In this paper, we discuss the possibility that ACE inhibitors might be affecting COVID-19 patients by causing zinc insufficiency.KEY MESSAGESZinc deficiency caused by chronic ACE inhibitor usage may exacerbate the pathogenicity of COVID-19 in susceptible patients.A multi-center study is needed to assess the zinc levels of patients with COVID-19 who are taking ACE inhibitors and other medications that may result in low zinc levels.
Subject(s)
Angiotensin-Converting Enzyme 2/metabolism , Angiotensin-Converting Enzyme Inhibitors/adverse effects , COVID-19 Drug Treatment , Zinc/deficiency , Angiotensin-Converting Enzyme 2/drug effects , Angiotensin-Converting Enzyme Inhibitors/administration & dosage , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/virology , Drug Interactions , Female , Humans , Male , Nutritional Status/drug effects , Pharmaceutical Preparations , Risk Factors , SARS-CoV-2/genetics , Severity of Illness Index , Zinc/bloodABSTRACT
BACKGROUND: Almost 80 percent of adults in the United States have had cytomegalovirus (CMV) infection by age 40. The number of symptomatic CMV hepatitis cases has been increasing along with non-alcoholic fatty liver disease (NAFLD) cases in the United States that is estimated to be 25 percent of the population. In this paper, we try to link these two entities together. CASE SUMMARY: In this case report, we describe a young female who presented with fever, nausea, and vomiting who was found to have NAFLD and CMV hepatitis that was treated supportively. CONCLUSION: In this case report, we describe NAFLD as a risk factor for CMV hepatitis and discuss the possible impact on clinical practice. We believe, it is essential to consider NAFLD and it's disease mechanisms' localized immu-nosuppression, as a risk factor of CMV hepatitis and severe coronavirus disease 2019 infection.