Multiple potential targets of opioids in the treatment of acute respiratory distress syndrome from COVID‐19

Cismaru, Cosmin Andrei; Cismaru, Gabriel; Nabavi, Seyed Fazel; Ghanei, Mostafa; Burz, Claudia; Nabavi, Seyed Mohammad; Berindan‐Neagoe, Ioana

doi:10.1111/jcmm.15927

Cited by 8 publications

(8 citation statements)

References 59 publications

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“…12 According to the World Blood Transfusion Association, about 341 antigens have been identified and categorized into 41 blood group systems. 13 ABO blood group system, as discovered by Landsteiner, is the most important blood group system. 14 The sequential additions of carbohydrates to an oligosaccharide backbone resulted in formation of three antigens, including A, B, and H. 15 Adding a terminal residue to the oligosaccharide backbone, creates the H antigen which then acts as a precursor for formation of A and B antigens.…”

Section: Blood Group Antigens and Diseasesmentioning

confidence: 99%

“…There are a number of carbohydrates and proteins on human red blood cell (RBC) membranes that are known as blood group antigens 12 . According to the World Blood Transfusion Association, about 341 antigens have been identified and categorized into 41 blood group systems 13 . ABO blood group system, as discovered by Landsteiner, is the most important blood group system 14 .…”

Section: Blood Group Antigens and Diseasesmentioning

confidence: 99%

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The relationship between blood groups and risk of infection with SARS‐CoV‐2 or development of severe outcomes: A review

Shokri

Golmohammadi

Noori

et al. 2021

Reviews in Medical Virology

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Summary The outbreak of coronavirus disease 2019 (COVID‐19), caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is considered a global catastrophe that has overwhelmed health care systems. Since initiation of the pandemic, identification of characteristics that might influence risk of infection and poor disease outcomes have been of paramount interest. Blood group phenotypes are genetically inherited characteristics whose association with certain infectious diseases have long been debated. The aim of this review is to identify whether a certain type of blood group may influence an individual’s susceptibility to SARS‐CoV‐2 infection and developing severe outcomes. Our review shows that blood group O protects individuals against SARS‐CoV‐2, whereas blood group A predisposes them to being infected. Although the association between blood groups and outcomes of COVID‐19 is not consistent, it is speculated that non‐O blood group carriers with COVID‐19 are at higher risk of developing severe outcomes in comparison to O blood group. The interaction between blood groups and SARS‐CoV‐2 infection is hypothesized to be as result of natural antibodies against blood group antigens that may act as a part of innate immune response to neutralize viral particles. Alternatively, blood group antigens could serve as additional receptors for the virus and individuals who are capable of expressing these antigens on epithelial cells, which are known as secretors, would then have a high propensity to be affected by SARS‐CoV‐2.

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Section: Blood Group Antigens and Diseasesmentioning

confidence: 99%

Section: Blood Group Antigens and Diseasesmentioning

confidence: 99%

The relationship between blood groups and risk of infection with SARS‐CoV‐2 or development of severe outcomes: A review

Shokri

Golmohammadi

Noori

et al. 2021

Reviews in Medical Virology

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show abstract

“…However, opioids also present side effects such as diarrhea, hyperalgesia, dysphoria, tolerance and dependence processes, their prolonged use might be associated to immunological system suppression, and high doses of opioids might lead to respiratory depression, exacerbating the poor respiratory condition of those patients ( Boom et al, 2012 ; Franchi et al, 2019 ; Cismaru et al, 2021 ). Patients with high doses of opioids might experience hypercapnia and hypoxia, due to the previously mentioned mechanisms, thus contributing to more severe respiratory symptoms ( LeGrand et al, 2003 ; Ataei et al, 2020 ; Velavan and Meyer, 2020 ).…”

Section: Resultsmentioning

confidence: 99%

Opioids in COVID-19: Two Sides of a Coin

et al. 2022

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Introduction: The treatment of most severe COVID-19 patients included the large-scale use of sedatives and analgesics–possibly in higher doses than usual–which was reported in the literature. The use of drugs that decrease mortality is necessary and opioids are important agents in procedures such as orotracheal intubation. However, these drugs seem to have been overestimated in the COVID-19 pandemic. We performed a review of the PubMed-Medline database to evaluate the use of opioids during this period. The following descriptors were used to enhance the search for papers: “Opioids”, “COVID-19,” “COVID-19 pandemic,” “SARS-CoV-2,” “Opioid use disorder,” “Opioid dependence” and the names of the drugs used. We also evaluated the distribution of COVID-19 patients in Brazil and the applicability of opioids in our country during the COVID-19 pandemic.Results: Several positive points were found in the use of opioids in the COVID-19 pandemic, for instance, they can be used for analgesia in orotracheal intubation, for chronic pain management, and as coadjutant in the management of acute intensification of pain. However, high doses of opioids might exacerbate the respiratory depression found in COVID-19 patients, their chronic use can trigger opioid tolerance and the higher doses used during the pandemic might result in greater adverse effects. Unfortunately, the pandemic also affected individuals with opioid use disorder, not only those individuals are at higher risk of mortality, hospitalization and need for ventilatory support, but measures taken to decrease the SARS-CoV-2 spread such as social isolation, might negatively affect the treatment for opioid use disorder. In Brazil, only morphine, remifentanil and fentanyl are available in the basic health care system for the treatment of COVID-19 patients. Out of the 5,273,598 opioid units used in this period all over the country, morphine, fentanyl, and remifentanil, accounted for, respectively, 559,270 (10.6%), 4,624,328 (87.6%), and 90,000 (1.8%) units. Many Brazilian regions with high number of confirmed cases of COVID-19 had few units of opioids available, as the Southeast region, with a 0.23 units of opioids per confirmed COVID-19 case, and the South region, with 0.05 units. In the COVID-19 pandemic scenario, positive points related to opioids were mainly the occurrence of analgesia, to facilitate intubation and their use as coadjutants in the management of acute intensification of pain, whereas the negative points were indiscriminate use, the presence of human immunosuppressor response and increased adverse effects due to higher doses of the drug.Conclusion: The importance of rational and individualized use of analgesic hypnotics and sedative anesthetics should be considered at all times, especially in situations of high demand such as the COVID-19 pandemic.

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“…In influenza and respiratory syncytial viruses (RSVs), opioids reduce the rate and severity of infection through anti-inflammatory and immunomodulatory functions (Salimi et al, 2013). Cismaru et al (2021) previously reported that none of the opioid medications are superior to others in treating dyspnea. So, oxycodone, hydromorphone fentanyl dihydrocodeine, diamorphine, and oral or parenteral morphine can be used for this purpose.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of COVID-19 outcomes in patients referred to opioid agonist treatment centers

et al. 2023

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Background: Coronavirus disease (COVID-19) is a mild to severe infectious respiratory illness caused by the SARS-CoV-2 virus. Based on the numerous pieces of evidence regarding the role of opioids in immune function, viral replication, and virus-mediated pathology, we decided to assess the incidence and severity of COVID-19 outcomes in people undergoing opioid maintenance treatment.Methods: This is a prospective, descriptive, multi-center study that included 452 patients undergoing maintenance treatment in opioid agonist treatment (OAT) clinics in different cities of Iran. Demographic information, underlying disease, history of maintenance treatment, type of drug used, history of addiction, smoking, and the kind of substance abused, were recorded. A physician evaluated the COVID-19 symptoms, and the severity of the disease was defined based on the number of observed symptoms.Results: The results have not shown any significant difference in the severity of COVID-19 symptoms in different nationalities, gender, and treatment groups. Furthermore, the history of drug abuse, including time and type of abuse and smoking, has not indicated any significant association with the occurrence of symptoms. Only the severity of COVID-19 in the mentioned cities (first and second follow-up: p < 0.001) and individuals with a history of underlying disease (first follow-up: p = 0.020; second follow-up: p = 0.043) were significantly different.Conclusion: Our results have demonstrated that the severity of symptoms in people with the underlying disease was significantly higher than in others. But there is no association between sex, race, treatment groups, and abuse history with the severity of COVID-19 symptoms in methadone maintenance treatment (MMT) patients.

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Multiple potential targets of opioids in the treatment of acute respiratory distress syndrome from COVID‐19

Cited by 8 publications

References 59 publications

The relationship between blood groups and risk of infection with SARS‐CoV‐2 or development of severe outcomes: A review

The relationship between blood groups and risk of infection with SARS‐CoV‐2 or development of severe outcomes: A review

Opioids in COVID-19: Two Sides of a Coin

Prevalence of COVID-19 outcomes in patients referred to opioid agonist treatment centers

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