Histamine receptors and COVID-19

Ennis, Madeleine; Tiligada, Ekaterini

doi:10.1007/s00011-020-01422-1

Cited by 46 publications

(45 citation statements)

References 84 publications

(103 reference statements)

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“…[28] Finally, it is possible that other medications not analyzed here may yet provide protection from SARS-CoV-2 infection that could confound our results with co-administration. Famotidine, although reported to have possible therapeutic effects and potentially used in higher rates with allergy medications, [29] was not analyzed here given our inability to separate outpatient use (which would be potentially preventive for SARS-CoV-2) from inpatient (therapeutic) use.…”

Section: Discussionmentioning

confidence: 99%

The influence of selection bias on identifying an association between allergy medication use and SARS-CoV-2 infection

Thompson¹,

Gurka²,

Filipp³

et al. 2021

eClinicalMedicine

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Background: Medications to prevent and treat SARS-CoV-2 infection are needed to complement emerging vaccinations. Recent in vitro and electronic health record (EHR) studies suggested that certain allergy medications could prevent SARS-CoV-2 infection. We sought to carefully examine the potential selection bias associated with utilizing EHRs in these settings. Methods: We analyzed associations of three allergy medications (cetirizine, diphenhydramine or hydroxyzine) with testing negative for SARS-CoV-2, measuring the potential effect of selection bias on these associations. We used a retrospective cohort of EHR data from 230,376 patients (18 years+) who visited outpatient clinicians in a single, large academic center at least once but were never hospitalized (10/1/2019À6/1/2020). Main exposures included EHR documentation of three allergy medications and allergy, with an intermediate outcome of receipt of a SARS-CoV-2 test, and the primary outcome as testing negative. Findings: SARS-CoV-2 testing rates varied by sex, age, race/ethnicity and insurance. Increasing age and public insurance were associated with a higher adjusted odds of test negativity, while being Black or Hispanic was significantly associated with test positivity. Allergy diagnosis and use of any of three allergy medications were each associated with a higher likelihood of receiving a test (e.g. diphenhydramine -Odds Ratio (OR) 2.99, 95% Confidence Interval (CI) 2.73, 3.28; cetirizine 1.75 (95% CI 1.60, 1.92)). Among those tested, only use of diphenhydramine was associated with a negative SARS-CoV-2 test (adjusted OR = 2.23, 95% CI 1.10, 4.55). However, analyses revealed that selection bias may be responsible for the apparent protective effect of diphenhydramine. Interpretation: Diphenhydramine use was associated with more SARS-CoV-2 testing and subsequent higher odds for negative tests. While EHR-based observational studies can inform a need for interventional trials, this study revealed limitations of EHR data. The finding that diphenhydramine documentation conferred a higher odds of testing negative for SARS-CoV-2 must be interpreted with caution due to probable selection bias.

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Section: Discussionmentioning

confidence: 99%

The influence of selection bias on identifying an association between allergy medication use and SARS-CoV-2 infection

Thompson¹,

Gurka²,

Filipp³

et al. 2021

eClinicalMedicine

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“…The different mast cell activation in pediatric SARS-CoV-2 has not yet been investigated, although we do not expect a significant difference in mast cell action. The use of H2 receptor antagonists, counteracting the effect of histamine and also having a potential immunomodulatory effect, has been hypothesized as a possible therapy for COVID-19, interfering with the progression towards severe forms [ 34 ].…”

Section: Immunological Response To Infectionmentioning

confidence: 99%

The Relationship between COVID-19 and Innate Immunity in Children: A Review

2021

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus responsible for the pandemic viral pneumonia that was first identified in Wuhan, China, in December 2019, and has since rapidly spread around the world. The number of COVID-19 cases recorded in pediatric age is around 1% of the total. The immunological mechanisms that lead to a lower susceptibility or severity of pediatric patients are not entirely clear. At the same time, the immune dysregulation found in those children who developed the multisystem inflammatory syndrome (MIC-S) is not yet fully understood. The aim of this review is to analyze the possible influence of children’s innate immune systems, considering the risk of contracting the virus, spreading it, and developing symptomatic disease or complications related to infection.

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“…Promethazine and terfenadine have been suggested to block SARS-CoV-2 endocytosis in respiratory epithelium [ 78 ]. A second-generation H1 receptor antagonist, rupatadine, has also been repurposed for COVID-19 [ 79 , 80 ]. More studies are needed to confirm the antiviral efficacy of H1 receptor antagonists on SARS-CoV-2 in lung epithelial cells ( Figure 2 ).…”

Section: Inhibition Of Sars-cov-2 By H1 Receptor Antagonistsmentioning

confidence: 99%

Could Histamine H1 Receptor Antagonists Be Used for Treating COVID-19?

Fuhler

Pan

2021

IJMS

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COVID-19 has rapidly become a pandemic worldwide, causing extensive and long-term health issues. There is an urgent need to identify therapies that limit SARS-CoV-2 infection and improve the outcome of COVID-19 patients. Unbalanced lung inflammation is a common feature in severe COVID-19 patients; therefore, reducing lung inflammation can undoubtedly benefit the clinical manifestations. Histamine H1 receptor (H1 receptor) antagonists are widely prescribed medications to treat allergic diseases, while recently it has emerged that they show significant promise as anti-SARS-CoV-2 agents. Here, we briefly summarize the novel use of H1 receptor antagonists in combating SARS-CoV-2 infection. We also describe the potential antiviral mechanisms of H1 receptor antagonists on SARS-CoV-2. Finally, the opportunities and challenges of the use of H1 receptor antagonists in managing COVID-19 are discussed.

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Histamine receptors and COVID-19

Cited by 46 publications

References 84 publications

The influence of selection bias on identifying an association between allergy medication use and SARS-CoV-2 infection

The influence of selection bias on identifying an association between allergy medication use and SARS-CoV-2 infection

The Relationship between COVID-19 and Innate Immunity in Children: A Review

Could Histamine H1 Receptor Antagonists Be Used for Treating COVID-19?

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