Ketamine in COVID‐19 patients: Thinking out of the box

Akinosoglou, Karolina; Γώγος, Αθανάσιος; Papageorgiou, Costas; Angelopoulos, Elias; Gogos, Charalambos

doi:10.1002/jmv.26681

Cited by 9 publications

(9 citation statements)

References 9 publications

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“…We previously reported that ( R,S )-ketamine produced a potent anti-inflammatory effects in treatment-resistant patients with depression [ 80 ]. Collectively, it is proposed that ( R,S )-ketamine may have beneficial effects for patients infected with SARS-CoV-2 [ 81 , 82 ]. At present, an open label study of ( R,S )-ketamine in patients infected with SARS-CoV-2 (ClinicalTrials.gov Identifier: NCT04365985) at Williams Beaumont Hospital (Michigan, USA) is underway.…”

Section: Other Candidate Cutamesine and Arketaminementioning

confidence: 99%

Repurposing of CNS drugs to treat COVID-19 infection: targeting the sigma-1 receptor

Hashimoto

2021

Eur Arch Psychiatry Clin Neurosci

115

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Section: Other Candidate Cutamesine and Arketaminementioning

confidence: 99%

Repurposing of CNS drugs to treat COVID-19 infection: targeting the sigma-1 receptor

Hashimoto

2021

Eur Arch Psychiatry Clin Neurosci

115

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“…Dexmedetomidine is commonly used in combination with ketamine during anesthesia and ventilation support during mechanical ventilation (Luscri and Tobias 2006 ). Ketamine also inhibits release of HMGB1 and NETs formation during ALI (Akinosoglou et al 2020 ). Further, ketamine has been shown to attenuate sepsis-induced ALI by down-regulating the HMGB1-RAGE pathway (Zhang et al 2018 ).…”

Section: Extracellular Hmgb1 Inhibitorsmentioning

confidence: 99%

High-mobility group box 1 (HMGB1) in COVID-19: extrapolation of dangerous liaisons

et al. 2022

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High-mobility group box 1 (HMGB1), a multifunctional nuclear protein, exists mainly within the nucleus of all mammal eukaryotic cells. It is actively secreted by the necrotic cells as a response to the inflammatory signaling pathway. HMGB1 binds to receptor ligands as RAGE, and TLR and becomes a pro-inflammatory cytokine with a robust capacity to trigger inflammatory response. It is a critical mediator of the pathogenesis of systemic inflammation in numerous inflammatory disorders. Release of HMGB1 is associated with different viral infections and strongly participates in the regulation of viral replication cycles. In COVID-19 era, high HMGB1 serum levels were observed in COVID-19 patients and linked with the disease severity, development of cytokine storm (CS), acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). SARS-CoV-2-induced cytolytic effect may encourage release of HMGB1 due to nuclear damage. Besides, HMGB1 activates release of pro-inflammatory cytokines from immune cells and up-regulation of angiotensin I-converting enzyme 2 (ACE2). Therefore, targeting of the HMGB1 pathway by anti-HMGB1 agents, such as heparin, resveratrol and metformin, may decrease COVID-19 severity. HMGB1 signaling pathway has noteworthy role in the pathogenesis of SARS-CoV-2 infections and linked with development of ALI and ARDS in COVID-19 patients. Different endogenous and exogenous agents may affect release and activation of HMGB1 pathway. Targeting of HMGB1-mediated TLR2/TLR4, RAGE and MAPK signaling, might be a new promising drug candidate against development of ALI and/or ARDS in severely affected COVID-19 patients.

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“…Its use has been described, with intranasal esketamine self-administered under clinical supervision via telemedicine [153]. The use of ketamine/ intravenous/intranasal esketamine in depressive episodes related to neuropsychiatric complications of COVID-19 should not be overlooked [154]. Ketamine seems to derive its therapeutic action, at least in part, from a decrease in the production of pro-inflammatory cytokines, including IL-6, involved in the immunopathology of COVID-19 [154].…”

Section: Management Of Resistant Depression With Covid-19mentioning

confidence: 99%

Psychotropics and COVID-19: An analysis of safety and prophylaxis

et al. 2021

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The use of psychotropics during the COVID-19 pandemic has raised two questions, in order of importance: first, what changes should be made to pharmacological treatments prescribed to mental health patients? Secondly, are there any positive side effects of these substances against SARS-CoV-2? Our aim was to analyze usage safety of psychotropics during COVID-19, therefore herein we have studied: (i) the risk of symptomatic complications of COVID-19 associated with the use of these drugs, notably central nervous system activity depression, QTc interval enlargement and infectious and thromboembolic complications, (ii) the risk of mistaking the iatrogenic impact of psychotropics with COVID-19 symptoms, causing diagnostic error. Moreover, we provided a summary of the different information available today for these risks, categorized by mental health disorder, for the following: schizophrenia, bipolar disorder, anxiety disorder, ADHD, sleep disorders and suicidal risk. The matter of psychoactive substance use during the pandemic is also analyzed in this paper, and guideline websites and publications for psychotropic treatments in the context of COVID-19 are referenced during the text, so that changes on those guidelines and eventual interaction between psychotropics and COVID-19 treatment medication can be reported and studied. Finally, we also provide a literature review of the latest known antiviral properties of psychotropics against SARS-CoV-2 as complementary information.

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Ketamine in COVID‐19 patients: Thinking out of the box

Cited by 9 publications

References 9 publications

Repurposing of CNS drugs to treat COVID-19 infection: targeting the sigma-1 receptor

Repurposing of CNS drugs to treat COVID-19 infection: targeting the sigma-1 receptor

High-mobility group box 1 (HMGB1) in COVID-19: extrapolation of dangerous liaisons

Psychotropics and COVID-19: An analysis of safety and prophylaxis

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