Can Adenosine Fight COVID-19 Acute Respiratory Distress Syndrome?

Falcone, Cristina; Caracciolo, Massimo; Correale, Pierpaolo; Macheda, Sebastiano; Vadalà, Eugenio; Scala, Stefano La; Tescione, Marco; Danieli, Roberta; Ferrarelli, Anna; Tarsitano, Maria Grazia; Romano, Lorenzo; Lorenzo, Antonino De

doi:10.3390/jcm9093045

Cited by 20 publications

(19 citation statements)

References 106 publications

(138 reference statements)

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“…The off-label treatment involved the use of inhaled adenosine (Krenosin®), 9 mg every 12 h for the first 24 h and subsequently, every 24 h for 4 days ( 43 , 44 ). Nebulized adenosine was delivered by an Aerogen USB® controller connected to a high flow 60 L for 5 min device, with 21% FiO 2 .…”

Section: Methodsmentioning

confidence: 99%

Efficacy and Effect of Inhaled Adenosine Treatment in Hospitalized COVID-19 Patients

Caracciolo¹,

Correale²,

Mangano³

et al. 2021

Front. Immunol.

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Lack of specific antiviral treatment for COVID-19 has resulted in long hospitalizations and high mortality rate. By harnessing the regulatory effects of adenosine on inflammatory mediators, we have instituted a new therapeutic treatment with inhaled adenosine in COVID-19 patients, with the aim of reducing inflammation, the onset of cytokine storm, and therefore to improve prognosis. The use of inhaled adenosine in COVID19 patients has allowed reduction of length of stay, on average 6 days. This result is strengthened by the decrease in SARS-CoV-2 positive days. In treated patients compared to control, a clear improvement in PaO2/FiO2 was observed together with a reduction in inflammation parameters, such as the decrease of CRP level. Furthermore, the efficacy of inhaled exogenous adenosine led to an improvement of the prognosis indices, NLR and PLR. The treatment seems to be safe and modulates the immune system, allowing an effective response against the viral infection progression, reducing length of stay and inflammation parameters.

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Section: Methodsmentioning

confidence: 99%

Efficacy and Effect of Inhaled Adenosine Treatment in Hospitalized COVID-19 Patients

Caracciolo¹,

Correale²,

Mangano³

et al. 2021

Front. Immunol.

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“…Falcone and coworkers demonstrated important benefits of aerosolized respiratory tract adenosine in SARS-CoV-2 acute respiratory distress due to a “cytokine storm” [ 17 ]. Adenosine modulates the A2AR receptor dependent immunomodulatory control in COVID-19 patients and dampens the SARS-CoV-2-induced cytokine storm.…”

mentioning

confidence: 99%

Cystic fibrosis improves COVID-19 survival and provides clues for treatment of SARS-CoV-2

Abraham

Guidotti

Rapaport

et al. 2021

Purinergic Signalling

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Systemic pools of ATP are elevated in individuals homozygous for cystic fibrosis (CF) as evidenced by elevated blood and plasma ATP levels. This elevated ATP level seems to provide benefit in the presence of advanced solid tumors (Abraham et al., Nature Medicine 2(5):593–596, 1996). We published in this journal a paper showing that IV ATP can elevate the depleted ATP pools of advanced cancer patients up to levels found in CF patients with subsequent clinical, biochemical, and quality of life (QOL) improvements (Rapaport et al., Purinergic Signalling 11(2): 251–262, 2015). We hypothesize that the elevated ATP levels seen in CF patients may be benefiting CF patients in another way: by improving their survival after contracting COVID-19. We discuss here the reasoning behind this hypothesis and suggest how these findings might be applied clinically in the general population.

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“…Moreover, patients who are obese have higher levels of inflammation, have compromised immune responses, and are often affected by additional comorbidities, such as diabetes, hypertension, congestive heart failure, and renal failure, that further increase their risk of developing life-threatening COVID-19. 86 In addition, excessive secretion of proinflammatory adipokines by large deposits of epicardial fat among patients who are obese may have a negative inotropic effect and may also favor the cytokine storm, contributing to the patient's demise. 87 Cancer per se does not seem to increase the risk of death on SARS-CoV-2 infection; however, therapies that impair the immune response and surgery may increase the risk of COVID-19 disease and related death.…”

Section: Covid-19 Epidemiology and Susceptibilitymentioning

confidence: 99%

Coronavirus 2019 Infectious Disease Epidemic: Where We Are, What Can Be Done and Hope For

Carbone

Lednicky²,

Xiao

et al. 2021

Journal of Thoracic Oncology

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spreads mainly by means of aerosols (microdroplets) in enclosed environments, especially those in which temperature and humidity are regulated by means of airconditioning. About 30% of individuals infected with SARS-CoV-2 develop coronavirus disease 2019 (COVID-19) disease. Among them, approximately 25% require hospitalization. In medicine, cases are identified as those who become ill. During this pandemic, cases have been identified as those with a positive SARS-CoV-2 polymerase chain reaction test, including approximately 70% who were asymptomatic-this has caused unnecessary anxiety. Individuals more than 65 years old, those affected by obesity, diabetes, asthma, or are immune-depressed owing to cancer and other conditions, are at a higher risk of hospitalization and of dying of COVID-19. Healthy individuals younger than 40 years very rarely die of COVID-19. Estimates of the COVID-19 mortality rate vary because the definition of COVID-19-related deaths varies. Belgium has the highest death rate at 154.9 per 100,000 persons, because it includes anyone who died with symptoms compatible with COVID-19, even those never tested for SARS-CoV-2. The United States includes all patients who died with a positive test, whether they died because of, or with, SARS-CoV-2. Countries that include only patients in which COVID-19 was the main cause of death, rather than a cofactor, have lower death rates. Numerous therapies are being developed, and rapid improvements are anticipated. Because of disinformation, only approximately 50% of the U.S. population plans to receive a COVID-19 vaccine. By sharing accurate information, physicians, health professionals, and scientists play a key role in addressing myths and anxiety, help public health officials enact measures to decrease infections, and provide the best care for those who become sick. In this article, we discuss these issues.

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Can Adenosine Fight COVID-19 Acute Respiratory Distress Syndrome?

Cited by 20 publications

References 106 publications

Efficacy and Effect of Inhaled Adenosine Treatment in Hospitalized COVID-19 Patients

Efficacy and Effect of Inhaled Adenosine Treatment in Hospitalized COVID-19 Patients

Cystic fibrosis improves COVID-19 survival and provides clues for treatment of SARS-CoV-2

Coronavirus 2019 Infectious Disease Epidemic: Where We Are, What Can Be Done and Hope For

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