RESUMEN
The ongoing Covid-19 is a contagious disease, and it is characterised by different symptoms such as fever, cough, and shortness of breath. Rising concerns about Covid-19 have severely affected the healthcare system in all countries as the Covid-19 outbreak has developed at a rapid rate all around the globe. Intriguing, a clinically used drug, acetazolamide (a specific inhibitor of carbonic anhydrase, CA, EC 4.2.1.1), is used to treat high-altitude pulmonary oedema (HAPE), showing a high degree of clinical similarities with the pulmonary disease caused by Covid-19. In this context, this preliminary study aims to provide insights into some factors affecting the Covid-19 patients, such as hypoxaemia, hypoxia as well as the blood CA activity. We hypothesise that patients with Covid-19 problems could show a dysregulated acid-base status influenced by CA activity. These preliminary results suggest that the use of CA inhibitors as a pharmacological treatment for Covid-19 may be beneficial.
Asunto(s)
Acetazolamida/uso terapéutico , Antivirales/uso terapéutico , Tratamiento Farmacológico de COVID-19 , Inhibidores de Anhidrasa Carbónica/uso terapéutico , Anhidrasas Carbónicas/sangre , Equilibrio Ácido-Base/efectos de los fármacos , Mal de Altura/sangre , Mal de Altura/tratamiento farmacológico , Anticonvulsivantes/uso terapéutico , Bicarbonatos/sangre , COVID-19/sangre , COVID-19/diagnóstico por imagen , COVID-19/virología , Dióxido de Carbono/sangre , Tos/sangre , Tos/tratamiento farmacológico , Tos/patología , Tos/virología , Reposicionamiento de Medicamentos , Disnea/sangre , Disnea/tratamiento farmacológico , Disnea/patología , Disnea/virología , Fiebre/sangre , Fiebre/tratamiento farmacológico , Fiebre/patología , Fiebre/virología , Humanos , Concentración de Iones de Hidrógeno , Hipertensión Pulmonar/sangre , Hipertensión Pulmonar/tratamiento farmacológico , Hipoxia/sangre , Hipoxia/tratamiento farmacológico , Hipoxia/patología , Hipoxia/virología , Oximetría , Proyectos de Investigación , SARS-CoV-2/patogenicidad , SARS-CoV-2/fisiología , Índice de Severidad de la Enfermedad , Tomografía Computarizada por Rayos XRESUMEN
Acute kidney injury (AKI) is an important complication of COVID-19 encompassing a wide range of presentations. SARS-CoV-2 is proposed to cause AKI in the patients through various mechanisms. We are, nevertheless, far from a comprehensive understanding of the underlying pathophysiological mechanisms of the kidney injury in this infection. AKI has been shown to be a marker of disease severity and also a negative prognostic factor for survival. Unfortunately, no effective preventive strategy to decrease the risk of kidney damage in these patients has yet been identified. In this hypothesis, we highlight the potential protective effects of acetazolamide, a carbonic anhydrase inhibitor, in preventing the proximal tubular damage caused by the virus through disrupting the virus-endosome fusion and also interfering with the lysosomal proteases. Our proposed mechanisms could pave the way for further in vitro studies and subsequent clinical trials.