Erythropoietin as candidate for supportive treatment of severe COVID-19

Ehrenreich, Hannelore; Weißenborn, Karin; Begemann, Martin; Busch, Markus; Vieta, Eduard; Miskowiak, Kamilla

doi:10.1186/s10020-020-00186-y

Cited by 56 publications

(79 citation statements)

References 103 publications

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“…Specifically, treatments that improve cognitive functions may also aid patients’ stress resilience and, thereby, their mental health outcomes after COVID-19 hospitalisation ( Vinkers et al, 2020 ). One of the most promising treatments is with the multifunctional hormone erythropoietin (EPO), which plays a key role in neuroprotection and neuroplasticity and has been found by our and other groups to improve cognitive functions across a range of neuropsychiatric diseases ( Ehrenreich et al, 2020 ). Future studies are thus warranted to investigate the potential of EPO to reverse cognitive impairments after COVID-19.…”

Section: Discussionmentioning

confidence: 99%

Cognitive impairments four months after COVID-19 hospital discharge: Pattern, severity and association with illness variables

Miskowiak

Johnsen

Sattler

et al. 2021

European Neuropsychopharmacology

286

262

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The ongoing Coronavirus Disease 2019 (COVID-19) pandemic has affected more than 100 million people and clinics are being established for diagnosing and treating lingering symptoms, so called long-COVID. A key concern are neurological and long-term cognitive complications. At the same time, the prevalence and nature of the cognitive sequalae of COVID-19 are unclear. The present study aimed to investigate the frequency, pattern and severity of cognitive impairments 3-4 months after COVID-19 hospital discharge, their relation to subjective cognitive complaints, quality of life and illness variables. We recruited patients at their follow-up visit at the respiratory outpatient clinic, Copenhagen University Hospital, Bispebjerg, approximately four months after hospitalisation with COVID-19. Patients underwent pulmonary, functional and cognitive assessments. Twenty-nine patients were included. The percentage of patients with clinically significant cognitive impairment ranged from 59-65% depending on the applied cut-off for clinical relevance of cognitive impairment, with verbal learning and executive functions being most affected. Objective cognitive impairment scaled with subjective cognitive complaints, lower work function and poorer quality of life. Cognitive impairments were associated with d-dimer levels during acute illness and residual pulmonary dysfunction. In conclusion, these findings provide new evidence for frequent cognitive sequelae of COVID-19 and indicate an association with the severity of the lung affection and potentially restricted cerebral oxygen delivery. Further, the associations with quality of life and functioning call for systematic cognitive screening of patients after recovery from severe COVID-19 illness and implementation of targeted treatments for patients with persistent cognitive impairments.

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Section: Discussionmentioning

confidence: 99%

Cognitive impairments four months after COVID-19 hospital discharge: Pattern, severity and association with illness variables

Miskowiak

Johnsen

Sattler

et al. 2021

European Neuropsychopharmacology

286

262

View full text Add to dashboard Cite

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“…The side effects of corticosteroids depend on several factors including the route of administration, the dose and the duration of treatment [ 109 ]. On the other hand, erythropoietin (EPO) which has emerged as a supportive treatment for patients with severe COVID-19, has a neuroprotective and neuro-regenerative effects [ 110 ].…”

Section: Neurological Side Effects Associated With Covid-19 Treatmmentioning

confidence: 99%

Acute and Post-Acute Neurological Complications of COVID-19

Al-Ramadan

Rabab’h

Shah

et al. 2021

Neurology International

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Coronavirus disease 2019 (COVID-19) is an emerging global health emergency caused by the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The global outbreak of SARS-CoV-2 infection has been declared a global pandemic by the World Health Organization (WHO). The clinical presentation of SARS-CoV-2 infection depends on the severity of the disease and may range from an asymptomatic infection to a severe and lethal illness. Fever, cough, and shortness of breath are among the most common symptoms associated with SARS-CoV-2 infection. Accumulating evidence indicates that COVID-19 patients commonly develop neurological symptoms, such as headache, altered mental status, anosmia, and myalgia. In this comprehensive literature review, we have summarized the most common neurological complications and reported neurological case studies associated with COVID-19, and neurological side effects associated with COVID-19 treatments. Additionally, the post-acute COVID-19 syndrome and long-term neurological complications were discussed. We also explained the proposed mechanisms that are involved in the pathogenesis of these neurological complications.

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“…In agreement with such evidence, here we show that a single administration of rhEPO promotes the functional recovery by hampering the histopathological features, such as the dopaminergic loss and neuroinflammation within the striatum. Remarkably, EPO has been proposed in the treatment of severely ill SARS-CoV2 patients to improve cell respiration in the lungs, brainstem, spinal cord and respiratory muscles, to counteract the severe inflammatory state caused by the cytokine storm, and to favor neuroprotection and neuroregeneration both in the CNS and the peripheral nervous system [ 69 , 70 , 71 ].…”

Section: Discussionmentioning

confidence: 99%

Mitochondrial Metabolism as Target of the Neuroprotective Role of Erythropoietin in Parkinson’s Disease

et al. 2021

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Existing therapies for Parkinson’s disease (PD) are only symptomatic. As erythropoietin (EPO) is emerging for its benefits in neurodegenerative diseases, here, we test the protective effect driven by EPO in in vitro (SH-SY5Y cells challenged by MPP+) and in vivo (C57BL/6J mice administered with MPTP) PD models. EPO restores cell viability in both protective and restorative layouts, enhancing the dopaminergic recovery. Specifically, EPO rescues the PD-induced damage to mitochondria, as shown by transmission electron microscopy, Mitotracker assay and PINK1 expression. Moreover, EPO promotes a rescue of mitochondrial respiration while markedly enhancing the glycolytic rate, as shown by the augmented extracellular acidification rate, contributing to elevated ATP levels in MPP+-challenged cells. In PD mice, EPO intrastriatal infusion markedly improves the outcome of behavioral tests. This is associated with the rescue of dopaminergic markers and decreased neuroinflammation. This study demonstrates cellular and functional recovery following EPO treatment, likely mediated by the 37 Kda isoform of the EPO-receptor. We report for the first time, that EPO-neuroprotection is exerted through restoring ATP levels by accelerating the glycolytic rate. In conclusion, the redox imbalance and neuroinflammation associated with PD may be successfully treated by EPO.

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Erythropoietin as candidate for supportive treatment of severe COVID-19

Cited by 56 publications

References 103 publications

Cognitive impairments four months after COVID-19 hospital discharge: Pattern, severity and association with illness variables

Cognitive impairments four months after COVID-19 hospital discharge: Pattern, severity and association with illness variables

Acute and Post-Acute Neurological Complications of COVID-19

Mitochondrial Metabolism as Target of the Neuroprotective Role of Erythropoietin in Parkinson’s Disease

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