Corticosteroid treatment in severe COVID-19 patients with acute respiratory distress syndrome

Liu, Jiao; Zhang, Sheng; Dong, Xuan; Li, Zhongyi; Xu, Qianghong; Feng, Hao; Cai, Jing; Huang, Sisi; Guo, Jun; Zhang, Lidi; Chen, Yizhu; Zhu, Wei; Du, Hangxiang; Liu, Yongan; Wang, Tao; Chen, Limin; Wen, Zhenliang; Annane, Djillali; Qu, Jieming; Chen, Dechang

doi:10.1172/jci140617

Cited by 117 publications

(130 citation statements)

References 29 publications

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“…Initial binding to heparan sulphates was suggested to trigger conformational changes ( Clausen et al, 2020 ; Mycroft-West et al, 2020 ) and to keep the spike protein within an ‘open’ conformation allowing for downstream binding and processing of ACE2 and host cell proteases, respectively ( W. Hao et al, 2020 ). It was proposed that while the receptor-binding domain of the SARS-CoV-2 spike (S) protein confers sequence specificity for heparan sulphates expressed by target cells, an additional HS binding site in the S1/S2 proteolytic cleavage site enhances the avidity of binding to ACE2 ( L. Liu et al, 2020 ). Recent studies suggest that multiple heparin and heparan sulfate binding sites are present on the SARS-CoV-2 spike protein; one at the S1/S2 furin cleavage site, and others at the S2 protein and within the receptor binding domain of S1 ( Partridge et al, 2020 ).…”

Section: Cardiovascular Drugs and Ace2mentioning

confidence: 99%

“… Moran et al (2017) Resveratrol Male C57BL/6 mice/ Increased aortic ACE2, immunostaining, protein and mRNA expression. E. N. Kim et al (2018) Resveratrol Sprague–Dawley rats/ High fat induced liver disease model Increased liver ACE2 mRNA and protein expression Tiao et al (2018) Quercetin Recombinant Human ACE2 activity assay Inhibition of ACE2 activity X. Liu et al (2020) β-casomorphin-7/ Opioid-like peptide Male Sprague-Dawley rats/ Streptozotocin induced diabetes model Increased renal ACE2 mRNA expression in ACE2 downregulated diabetic rats, W. Zhang, Miao, Wang, and Zhang (2013) Geranium essential oil HT-29 cells Inhibition of ACE2 activity and protein and mRNA expression Senthil Kumar et al (2020) Lemon essential oil HT-29 cells Inhibition of ACE2 activity and protein and mRNA expression Senthil Kumar et al (2020) Caerulein/ Cholecystokinin analog Male C57BL/6 mice/ Caerulein and lipopolysaccharide induced pancreatitis model Marked increase in pancreatic ACE2 mRNA, protein expression and immunostaining Y. Wang, J. Wang, et al (2012) Cerulein/ Cholecystokinin analog Male C57BL/6, ACE2 knockout and ACE2 transgenic mice/ Caerulein and lipopolysaccharide induced pancreatitis model Marked increase in pancreatic ACE2 mRNA and protein expression and immunostaining R. Liu et al (2014a) Cerulein/ Cholecystokinin analog Rat pancreatic acinar AR42J cells Increase in ACE2 protein expression up to 6 hours, Decrease ACE2 at later time points J. Wang et al (2015) Caerulein/ Cholecystokinin analog Male C57BL/6 mice/ Caerulein induced pancreatitis model No change in pancreatic and pulmonary ACE2 protein level but increased ACE2 activity in pancreatic tissue Gaddam, Ang, Badiei, Chambers, & Bhatia (2015) Taurine/ Naturally occurring organic compound and food additive Male Wistar rats/ Stress induced hypertension model Increased adrenal gland ACE2 mRNA and protein expression. No effect on hypothalamus and pituitary …”

Section: Phytochemicals and Naturally Occurring Substances And Ace2mentioning

confidence: 99%

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A comprehensive guide to the pharmacologic regulation of angiotensin converting enzyme 2 (ACE2), the SARS-CoV-2 entry receptor

Öz

Lorke

Kabbani

2021

Pharmacology & Therapeutics

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The recent emergence of coronavirus disease-2019 (COVID-19) as a global pandemic has prompted scientists to address an urgent need for defining mechanisms of disease pathology and treatment. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent for COVID-19, employs angiotensin converting enzyme 2 (ACE2) as its primary target for cell surface attachment and likely entry into the host cell. Thus, understanding factors that may regulate the expression and function of ACE2 in the healthy and diseased body is critical for clinical intervention. Over 66% of all adults in the United States are currently using a prescription drug and while earlier findings have focused on possible upregulation of ACE2 expression through the use of renin angiotensin system (RAS) inhibitors, mounting evidence suggests that various other widely administered drugs used in the treatment of hypertension, heart failure, diabetes mellitus, hyperlipidemias, coagulation disorders, and pulmonary disease may also present a varied risk for COVID-19. Specifically, we summarize mechanisms on how heparin, statins, steroids and phytochemicals, besides their established therapeutic effects, may also interfere with SARS-CoV-2 viral entry into cells. We also describe evidence on the effect of several vitamins, phytochemicals, and naturally occurring compounds on ACE2 expression and activity in various tissues and disease models. This comprehensive review aims to provide a timely compendium on the potential impact of commonly prescribed drugs and pharmacologically active compounds on COVID-19 pathology and risk through regulation of ACE2 and RAS signaling.

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Section: Cardiovascular Drugs and Ace2mentioning

confidence: 99%

Section: Phytochemicals and Naturally Occurring Substances And Ace2mentioning

confidence: 99%

A comprehensive guide to the pharmacologic regulation of angiotensin converting enzyme 2 (ACE2), the SARS-CoV-2 entry receptor

Öz

Lorke

Kabbani

2021

Pharmacology & Therapeutics

View full text Add to dashboard Cite

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“…There were several reports about observational cohorts on the use of corticosteroids in patients with COVID-19 [ 1 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 ]. Table 1 summarizes the main characteristics of these observational studies.…”

Section: Summary Of the Clinical Evidence Of Corticosteroids Effects mentioning

confidence: 99%

Corticosteroids for COVID-19

Annane¹

2021

Journal of Intensive Medicine

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COVID-19 is placing a major burden on healthcare, economy and social systems worldwide owing to its fast spread and unacceptably high death toll. The unprecedented research effort has established the role of a deregulated immune response to the severe acute respiratory syndrome coronavirus 2 resulting in systemic inflammation. Thereafter, the immunomodulatory approach has been place in the top list of the research agenda for COVID-19. Corticosteroids have been used for more than 70 years for modulating immune response in a broad variety of disease. These drugs have been shown to prevent and attenuate the inflammation both in tissues and in the circulation via non-genomic and genomic effects. At the bedside, numerous observational cohorts have been published the past months and have been inconclusive. Randomized controlled trials with subsequent high quality meta-analyses have provided moderate to strong certainty for increased chance of survival and relief from life supportive therapy with corticosteroids given at a dose of 6mg per day of dexamethasone or equivalent doses of hydrocortisone or methylprednisolone. The corticotherapy was not associated with increased risk of bacterial infection or of delayed viral clearance. In daily practice, physicians may be encouraged to use to corticosteroids when managing patients with COVID-19 requiring oxygen supplementation.

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“…Because some high-quality randomized clinical trials (RCTs) [7][8][9] on the effect of corticosteroids on patients with COVID-19 recently were published, recognizing the urgency of evaluating the e cacy of corticosteroids to guide clinical management, we intend to conduct a systematic review and metaanalysis of RCTs on corticosteroid therapy to evaluate the effect on survival of patients with COVID-19 with different disease severity.…”

Section: Introductionmentioning

confidence: 99%

Corticosteroids Treatment for Patients With Coronavirus Disease-2019 (COVID-19) With Different Disease Severity: a Systematic Review and Meta-analysis Protocol

Lou

Huang

Jiang

et al. 2021

Preprint

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Introduction: As the coronavirus disease 2019 (COVID-19) pandemic progresses, identifying effective antiviral agents to treat the COVID-19 is of most urgency. Efficacy and safety of corticosteroids in patients with COVID-19 still are debated. Because high-quality randomized clinical trials (RCTs) on the use of corticosteroids for patients with COVID-19 recently were published recently, we aim to conduct a systematic review and meta-analysis of RCTs on corticosteroids therapy in patients with different disease severity to ascertain the effect on survival. Methods: We will undertake a comprehensive literature search among PubMed, EMBASE, Cochrane Library, medRxiv, and bioRxiv from their inception onwards to identify relevant RCTs. Two reviewers will independently extract data and conduct risk of bias assessments. The primary outcome is all-cause mortality, mortality of mechanically ventilated patients and patients who did not receive oxygen therapy. Secondary outcomes include need for mechanical ventilation or oxygen therapy and incidence of adverse outcomes. Heterogeneity of the estimates across studies will be assessed. Outcomes will be analyzed to pooled risk ratio and pertinent 95% confidence interval. A subgroup analysis will be conducted by disease severity to explore the source of heterogeneity. The systematic review and meta-analysis will be presented according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses. Discussion: This systematic review will provide an overview of the current state of evidence concerning the effect of corticosteroids on survival of patients with COVID-19 depended on the disease severity. Also, this systematic review will show the limitations and strengths of the studies available in the literature, as well as recommendations for future avenues of research will be given. PROSPERO registration number: CRD42020227740.

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Corticosteroid treatment in severe COVID-19 patients with acute respiratory distress syndrome

Cited by 117 publications

References 29 publications

A comprehensive guide to the pharmacologic regulation of angiotensin converting enzyme 2 (ACE2), the SARS-CoV-2 entry receptor

A comprehensive guide to the pharmacologic regulation of angiotensin converting enzyme 2 (ACE2), the SARS-CoV-2 entry receptor

Corticosteroids for COVID-19

Corticosteroids Treatment for Patients With Coronavirus Disease-2019 (COVID-19) With Different Disease Severity: a Systematic Review and Meta-analysis Protocol

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