Can iron chelation as an adjunct treatment of COVID-19 improve the clinical outcome?

Abobaker, Anis

doi:10.1007/s00228-020-02942-9

Cited by 32 publications

(30 citation statements)

References 10 publications

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“…However, this molecule is claimed as responsible of chelating the iron whose dissociation from heme is increased by SARS-CoV-2, causing oxidative stress and damage to the lung. 77 The top 2% also contains antivirals such as ledipasvir and elbasvir, used against hepatitis C. However, their mechanism of action involves the inhibition of viral proteins. Additionally, both elbasvir and ledipasvir were identified on the same target in another independent study, using a different computational protocol.…”

Section: Resultsmentioning

confidence: 99%

In Silico Drug Repurposing for SARS-CoV-2 Main Proteinase and Spike Proteins

Maffucci

Contini

2020

J. Proteome Res.

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The pandemic caused by SARS-CoV-2 is currently representing a major health and economic threat to humanity. So far, no specific treatment to this viral infection has been developed and the emergency still requires an efficient intervention. In this work, we used virtual screening to facilitate drug repurposing against SARS-CoV-2, targeting viral main proteinase and spike protein with 3000 existing drugs. We used a protocol based on a docking step followed by a short molecular dynamic simulation and rescoring by the Nwat-MMGBSA approach. Our results provide suggestions for prioritizing in vitro and/or in vivo tests of already available compounds.

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Section: Resultsmentioning

confidence: 99%

In Silico Drug Repurposing for SARS-CoV-2 Main Proteinase and Spike Proteins

Maffucci

Contini

2020

J. Proteome Res.

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“…This is very unlikely since COVID‐19 has been associated with the hyperferritinemic syndrome spectrum with the potential deleterious effect of the high level of ferritin and free iron (Perricone et al., 2020). Iron chelation and iron depletion therapy have been proposed as a novel therapeutic approach (Abobaker, 2020; Perricone et al., 2020) but this treatment is not supported by experimental or clinical results and remains speculative.…”

Section: Are the Medications And Methods Used For High‐altitude Illnementioning

confidence: 99%

Altitude and COVID‐19: Friend or foe? A narrative review

et al. 2020

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Recent reports suggest that high‐altitude residence may be beneficial in the novel coronavirus disease (COVID‐19) implicating that traveling to high places or using hypoxic conditioning thus could be favorable as well. Physiological high‐altitude characteristics and symptoms of altitude illnesses furthermore seem similar to several pathologies associated with COVID‐19. As a consequence, high altitude and hypoxia research and related clinical practices are discussed for potential applications in COVID‐19 prevention and treatment. We summarize the currently available evidence on the relationship between altitude/hypoxia conditions and COVID‐19 epidemiology and pathophysiology. The potential for treatment strategies used for altitude illnesses is evaluated. Symptomatic overlaps in the pathophysiology of COVID‐19 induced ARDS and high altitude illnesses (i.e., hypoxemia, dyspnea…) have been reported but are also common to other pathologies (i.e., heart failure, pulmonary embolism, COPD…). Most treatments of altitude illnesses have limited value and may even be detrimental in COVID‐19. Some may be efficient, potentially the corticosteroid dexamethasone. Physiological adaptations to altitude/hypoxia can exert diverse effects, depending on the constitution of the target individual and the hypoxic dose. In healthy individuals, they may optimize oxygen supply and increase mitochondrial, antioxidant, and immune system function. It is highly debated if these physiological responses to hypoxia overlap in many instances with SARS‐CoV‐2 infection and may exert preventive effects under very specific conditions. The temporal overlap of SARS‐CoV‐2 infection and exposure to altitude/hypoxia may be detrimental. No evidence‐based knowledge is presently available on whether and how altitude/hypoxia may prevent, treat or aggravate COVID‐19. The reported lower incidence and mortality of COVID‐19 in high‐altitude places remain to be confirmed. High‐altitude illnesses and COVID‐19 pathologies exhibit clear pathophysiological differences. While potentially effective as a prophylactic measure, altitude/hypoxia is likely associated with elevated risks for patients with COVID‐19. Altogether, the different points discussed in this review are of possibly some relevance for individuals who aim to reach high‐altitude areas. However, due to the ever‐changing state of understanding of COVID‐19, all points discussed in this review may be out of date at the time of its publication.

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“…Despite this, blind supplementation of patients with iron can be a double-edged sword, since excess serum iron and hyperferritinemia in those affected by COVID-19 are also associated with increased inflammation and tissue fibrosis [125]. In this context, iron chelation can be used as a supportive treatment for COVID-19 related iron overload, which has also shown antiviral and antifibrotic proprieties [125], in an attempt to reduce disease severity and improve clinical outcomes [126].…”

Section: Ironmentioning

confidence: 99%

Current State of Evidence: Influence of Nutritional and Nutrigenetic Factors on Immunity in the COVID-19 Pandemic Framework

2020

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The pandemic caused by the new coronavirus has caused shock waves in many countries, producing a global health crisis worldwide. Lack of knowledge of the biological mechanisms of viruses, plus the absence of effective treatments against the disease (COVID-19) and/or vaccines have pulled factors that can compromise the proper functioning of the immune system to fight against infectious diseases into the spotlight. The optimal status of specific nutrients is considered crucial to keeping immune components within their normal activity, helping to avoid and overcome infections. Specifically, the European Food Safety Authority (EFSA) evaluated and deems six vitamins (D, A, C, Folate, B6, B12) and four minerals (zinc, iron, copper and selenium) to be essential for the normal functioning of the immune system, due to the scientific evidence collected so far. In this report, an update on the evidence of the contribution of nutritional factors as immune-enhancing aspects, factors that could reduce their bioavailability, and the role of the optimal status of these nutrients within the COVID-19 pandemic context was carried out. First, a non-systematic review of the current state of knowledge regarding the impact of an optimal nutritional status of these nutrients on the proper functioning of the immune system as well as their potential role in COVID-19 prevention/treatment was carried out by searching for available scientific evidence in PubMed and LitCovid databases. Second, a compilation from published sources and an analysis of nutritional data from 10 European countries was performed, and the relationship between country nutritional status and epidemiological COVID-19 data (available in the Worldometers database) was evaluated following an ecological study design. Furthermore, the potential effect of genetics was considered through the selection of genetic variants previously identified in Genome-Wide Association studies (GWAs) as influencing the nutritional status of these 10 considered nutrients. Therefore, access to genetic information in accessible databases (1000genomes, by Ensembl) of individuals from European populations enabled an approximation that countries might present a greater risk of suboptimal status of the nutrients studied. Results from the review approach show the importance of maintaining a correct nutritional status of these 10 nutrients analyzed for the health of the immune system, highlighting the importance of Vitamin D and iron in the context of COVID-19. Besides, the ecological study demonstrates that intake levels of relevant micronutrients—especially Vitamins D, C, B12, and iron—are inversely associated with higher COVID-19 incidence and/or mortality, particularly in populations genetically predisposed to show lower micronutrient status. In conclusion, nutrigenetic data provided by joint assessment of 10 essential nutrients for the functioning of the immune system and of the genetic factors that can limit their bioavailability can be a fundamental tool to help strengthen the immune system of individuals and prepare populations to fight against infectious diseases such as COVID-19.

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Can iron chelation as an adjunct treatment of COVID-19 improve the clinical outcome?

Cited by 32 publications

References 10 publications

In Silico Drug Repurposing for SARS-CoV-2 Main Proteinase and Spike Proteins

In Silico Drug Repurposing for SARS-CoV-2 Main Proteinase and Spike Proteins

Altitude and COVID‐19: Friend or foe? A narrative review

Current State of Evidence: Influence of Nutritional and Nutrigenetic Factors on Immunity in the COVID-19 Pandemic Framework

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