Scientific hypothesis and rational pharmacological for the use of sacubitril/valsartan in cardiac damage caused by COVID-19

Vitiello, Antonio; Porta, Raffaele La; Ferrara, Francesco

doi:10.1016/j.mehy.2021.110486

Cited by 29 publications

(15 citation statements)

References 70 publications

(39 reference statements)

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“…COVID-19 infection in most cases is asymptomatic or slightly symptomatic; however in a small percentage of cases, especially in elderly people and those with pre-existing conditions, the infection can be severe and in some cases fatal (Ruan et al 2020 ; Yang et al 2020 ). Although respiratory symptoms are predominant (Ferrara et al 2020a ), in the most severe stages of infection, multi-organ dysfunction can occur (Vitiello et al 2021c ; Ferrara and Vitiello 2021a ) due to an abnormal and generalized inflammatory response (Vitiello et al 2021b ; Vitiello and Ferrara 2021a , b ), causing injury to vital organs such as the lungs, heart, liver, and CNS (Shi et al 2020 ; Vitiello et al 2020a ). Most patients with COVID-19 have a good prognosis, and rapid healing times; however, patients with diseases, such as diabetes, hypertension, and heart disease, are at greater risk of serious complications; this suggests that during the COVID-19, infection treatment of the underlying diseases should not be interrupted (Ferrara 2020 ; Guo et al 2020 ).…”

Section: Introductionmentioning

confidence: 99%

The renin-angiotensin system and specifically angiotensin-converting enzyme 2 as a potential therapeutic target in SARS-CoV-2 infections

Ferrara

Vitiello

2021

Naunyn-Schmiedeberg's Arch Pharmacol

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In March 2019, the global COVID-19 pandemic caused by the novel SARS-CoV-2 coronavirus began. The first cases of SARS-CoV-2 infection occurred in November 19 in Wuhan, China. Preventive measures taken have not prevented the rapid spread of the virus to countries around the world. To date, there are approximately 3 million deaths, and a massive worldwide vaccination campaign has recently begun. SARS-CoV-2 uses the ACE-2 protein as an intracellular carrier. ACE-2 is a key component of the renin-angiotensin system (RAS), a key regulator of cardiovascular function. Considering the key role of ACE-2 in COVID-19 infection, both as an entry receptor and as a protective role, especially for the respiratory tract, and considering the variations of ACE-2 during the phases of viral infection, it is clear the important role that pharmacological regulation of RAS and ACE-2 may take. In this article, we describe the importance of ACE-2 in COVID-19 infection, the pharmacological aspects of a modulation with RAS-modifying agents, new therapeutic strategies, trying to provide a deep understanding and explanation of the complex mechanisms underlying the relationship between the virus and ACE-2, providing opinions and personal hypotheses on the best strategies of therapeutic intervention.

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Section: Introductionmentioning

confidence: 99%

The renin-angiotensin system and specifically angiotensin-converting enzyme 2 as a potential therapeutic target in SARS-CoV-2 infections

Ferrara

Vitiello

2021

Naunyn-Schmiedeberg's Arch Pharmacol

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“…At this stage we could also consider a triple therapy hydroxychloroquine colchicine and dexamethasone to block the inflammatory cascade on multiple points. Other pharmacologic agents may be considered for the management of severe COVID-19 complications [44][45][46][47][48].…”

Section: Pharmacological Rationale To Management Inflammation Colchicine In Covid-19 Infectionmentioning

confidence: 99%

Colchicine and SARS-CoV-2: Management of the hyperinflammatory state

Vitiello¹,

Ferrara²

2021

Respiratory Medicine

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The global COVID-19 pandemic is currently underway. In December 2020, the European Agency of Medicine (EMA) licensed the first Sars-CoV-2 vaccine. Therapeutic management of the COVID-19 positive patient should primarily aim to avoid the severe complications and organ injury caused by generalized inflammation caused by a cytokine storm and occurring in the most severe stages of viral infection. Current knowledge of the pathophysiological mechanisms of SARS-CoV-2 suggests a central role for exaggerated activation of the innate immune system as an important contributor to the adverse outcomes of COVID-19. Several studies have shown that blocking the cytokine storm or acting early with prevention of it can be effective; studies are underway to evaluate agents that may be able to reduce this hyperinflammatory state. The search for effective management strategies for COVID-19 continues to evolve. The actions of colchicine, one of the oldest anti-inflammatory therapies, target multiple targets associated with excessive COVID-19 inflammation. Colchicine is easily administered, generally well tolerated, and inexpensive. This article reports the scientific and molecular rationale for the use of colchicine as monotherapy or in combination in the various stages of SARS-CoV-2 infection to modulate and control the inflammatory state. Low-dose colchicine may be considered safe and effective for the treatment and prevention of cytokine storm in patients with SARS-CoV-2 infection, particularly as an adjunctive remedy to other therapeutic agents. Well-organized clinical studies are needed in this direction.

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“…In December 2020, the first COVID-19 vaccinations began. However, pharmacological treatments of COVID-19 infection are mostly experimental, directed at avoiding serious complications of the disease [2][3][4]. Among the various pharmacological agents used, some antivirals indicated for other viral diseases, such as remdesivir, have shown good anti-COVID-19 efficacy [5].…”

Section: Sars-cov-2 (Covid-19)mentioning

confidence: 99%

Plausible Positive Effects of Statins in COVID-19 Patient

Vitiello¹,

Ferrara²

2021

Cardiovasc Toxicol

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Since the onset of the global COVID-19 pandemic, there has been much discussion about the advantages and disadvantages of ongoing chronic drug therapies in SARS-CoV-2-positive patients. These discussions include also statins treatment. The statins are among the most widely used drugs in the global population. Statins aim to lower cholesterol, which is essential for many biological processes but can lead to heart disease if levels are too high; however, also the pleiotropic effects of statins are well known. So could the anti-inflammatory or the potential antiviral effects of statins be helpful in avoiding extreme inflammation and severity in COVID-19? To date, there are conflicting opinions on the effects of statins in the course of COVID-19 infection. The aim of this article is to describe the molecular and pharmacological basis of the pleiotropic effects of statins that could be more involved in the fight against COVID-19 infection and to investigate the current epidemiological evidence in the literature on the current and important topic.

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Scientific hypothesis and rational pharmacological for the use of sacubitril/valsartan in cardiac damage caused by COVID-19

Cited by 29 publications

References 70 publications

The renin-angiotensin system and specifically angiotensin-converting enzyme 2 as a potential therapeutic target in SARS-CoV-2 infections

The renin-angiotensin system and specifically angiotensin-converting enzyme 2 as a potential therapeutic target in SARS-CoV-2 infections

Colchicine and SARS-CoV-2: Management of the hyperinflammatory state

Plausible Positive Effects of Statins in COVID-19 Patient

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