Acetazolamide, Nifedipine and Phosphodiesterase Inhibitors: Rationale for Their Utilization as Adjunctive Countermeasures in the Treatment of Coronavirus Disease 2019 (COVID-19)

Solaimanzadeh, Isaac

doi:10.7759/cureus.7343

Cited by 82 publications

(113 citation statements)

References 26 publications

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“…It was also recently suggested that acetazolamide may useful in the treatment of respiratory conditions in COVID-19 patients [10]. Acetazolamide is a carbonic anhydrase inhibitor.…”

Section: Acetazolamide Treatmentmentioning

confidence: 99%

“…It was even postulated recently, based upon analyzing clinical data reported in published studies, that there was a striking similarity between high altitude pulmonary edema (HAPE) as manifested during the acute hypoxic ventilatory response and COVID-19 [10]. This researcher observed the following similarities: arterial oxygen partial pressure to fractional inspired oxygen ratio (decreased), hypoxia (present), tachypnea (increased), partial pressure of carbon dioxide level (decreased), ground glass opacities on chest CT (present), patchy infiltrates on chest x-ray (present), fibrinogen levels/fibrin formation (increased), alveolar comprise (present), and ARDS development in severe disease (present).…”

Section: Introductionmentioning

confidence: 99%

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Respiratory conditions in coronavirus disease 2019 (COVID-19): Important considerations regarding novel treatment strategies to reduce mortality

Geier¹,

Geier²

2020

Medical Hypotheses

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“…It was also recently suggested that acetazolamide may useful in the treatment of respiratory conditions in COVID-19 patients [10]. Acetazolamide is a carbonic anhydrase inhibitor.…”

Section: Acetazolamide Treatmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Respiratory conditions in coronavirus disease 2019 (COVID-19): Important considerations regarding novel treatment strategies to reduce mortality

Geier¹,

Geier²

2020

Medical Hypotheses

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“…Solaimanzadeh 54 reviewed the data published about the pathophysiology of Covid‐19 following a characterization of the disease vis‐à‐vis a similar respiratory illness, the high‐altitude pulmonary edema (HAPE), as manifested during the acute hypoxic ventilatory response, and proposed potential treatment options for Covid‐19. In severe cases, both Covid‐19 and HAPE exhibit a decreased ratio of arterial oxygen partial response pressure to fractional inspired oxygen (PaO 2 :Fi O 2 ratio) with concomitant hypoxia and tachypnea 54 . There was a reported tendency for low carbon dioxide levels, then hypoxia and hypocapnia are seen in both conditions 54 .…”

Section: Hypercoagulability and Viral Infectionsmentioning

confidence: 99%

“…In severe cases, both Covid‐19 and HAPE exhibit a decreased ratio of arterial oxygen partial response pressure to fractional inspired oxygen (PaO 2 :Fi O 2 ratio) with concomitant hypoxia and tachypnea 54 . There was a reported tendency for low carbon dioxide levels, then hypoxia and hypocapnia are seen in both conditions 54 . Radiologic findings of ground‐glass opacities are present in up to 86% of Covid‐19´patients with 76% having bilateral distribution and 33% peripheral.…”

Section: Hypercoagulability and Viral Infectionsmentioning

confidence: 99%

Lessons from dermatology about inflammatory responses in Covid‐19

Criado

Pagliari

Carneiro

et al. 2020

Reviews in Medical Virology

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Summary The SARS‐Cov‐2 is a single‐stranded RNA virus composed of 16 non‐structural proteins (NSP 1‐16) with specific roles in the replication of coronaviruses. NSP3 has the property to block host innate immune response and to promote cytokine expression. NSP5 can inhibit interferon (IFN) signalling and NSP16 prevents MAD5 recognition, depressing the innate immunity. Dendritic cells, monocytes, and macrophages are the first cell lineage against viruses' infections. The IFN type I is the danger signal for the human body during this clinical setting. Protective immune responses to viral infection are initiated by innate immune sensors that survey extracellular and intracellular space for foreign nucleic acids. In Covid‐19 the pathogenesis is not yet fully understood, but viral and host factors seem to play a key role. Important points in severe Covid‐19 are characterized by an upregulated innate immune response, hypercoagulopathy state, pulmonary tissue damage, neurological and/or gastrointestinal tract involvement, and fatal outcome in severe cases of macrophage activation syndrome, which produce a ‘cytokine storm’. These systemic conditions share polymorphous cutaneous lesions where innate immune system is involved in the histopathological findings with acute respiratory distress syndrome, hypercoagulability, hyperferritinemia, increased serum levels of D‐dimer, lactic dehydrogenase, reactive‐C‐protein and serum A amyloid. It is described that several polymorphous cutaneous lesions similar to erythema pernio, urticarial rashes, diffuse or disseminated erythema, livedo racemosa, blue toe syndrome, retiform purpura, vesicles lesions, and purpuric exanthema or exanthema with clinical aspects of symmetrical drug‐related intertriginous and flexural exanthema. This review describes the complexity of Covid‐19, its pathophysiological and clinical aspects.

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“…A s medical providers around the world struggle to care for patients with acute respiratory failure secondary to corona virus disease 2019 (COVID-19), extensive efforts have been made to compare this entity to other forms of acute respiratory failure observed prior to the current pandemic. Among the variety of theories put forth, one argument that has been made and amplified via social media is that COVID-19 lung injury is not like typical acute respiratory distress syndrome (ARDS) and instead is similar to high altitude pulmonary edema (HAPE) (Solaimanzadeh, 2020). As a group of physicians who have in some cases cared for patients with COVID-19 and in all cases cared for patients with HAPE and studied its pathophysiology and management, we feel it is important to correct this misconception, as continued amplification of this message could have adverse effects on management of these patients.…”

mentioning

confidence: 99%