Erythropoietin‐induced hemoglobin subunit beta may stimulate innate immune RNA virus pattern recognition, suppress reactive oxygen species, reduce ACE2 viral doorway opening, and neutrophil extracellular traps against COVID‐19

Abstract

Erythropoietin may stimulate innate immunity against RNA viruses, such as Covid‐19, through hemoglobin sub‐unit Beta acting on the retinoic acid inducible gene I (RIG‐1) and melanoma differentiation associated gene 5 (MDA5) viral pattern recognition receptors, causing interferon production and also maintains the vascular endothelium, a major target of SARS‐CoV‐2, possibly reducing thrombotic events which are becoming increasingly recognized complications of COVID19. This article is protected by copyright. All rights reserved.

Pneumolysis: a fundamental concept in COVID-19 lung disease

“…We and others have also suggested the use of erythropoietin in the treatment of severe pneumolysis cases (Ehrenreich et al, 2020;Soliz et al, 2020; as it can help improve the oxygen transport to tissues of the compromised oxygen transport triad (pneumo-dynamic pump, hemo-dynamic pump, and hemoglobin) described before . Several other authors are also suggesting the use of erythropoietin due not only to the increase of red blood cells, hematocrit and hemoglobin but also to the neuroprotective effects of the hormone itself in different tissues like the heart, the vessels, and the brain (Brenner, 2021;Ehrenreich et al, 2020;Fishbane and Hirsch, 2020;Hadadi et al, 2020;Leventhal et al, 2020;Sahebnasagh et al, 2020).Furthermore, the increase of hemoglobin becomes a fundamental factor of hypoxia tolerance as previously described in the Formula of Tolerance to hypoxia = Hb/PaCO2 * 3.01. This formula states that higher hemoglobin and a lower PaCO2 give greater tolerance to hypoxia (Zubieta-Calleja, G.R., Ardaya, G., Zubieta, N., Paulev, 2013).…”

Neurological Complications Associated with the Blood-Brain Barrier Damage Induced by the Inflammatory Response During SARS-CoV-2 Infection

“…On the other hand, the viral RNA activates typical molecules such as the retinoic acid inducible gene 1 and the melanoma differentiation associated gene 5 and induces an antiviral state, in which interferons (IFN) are secreted (mainly IFN type I and III). Interferons are molecules important to clearance the viral infection to prevent viruses from replicating [112,113]. In patients with COVID-19, high levels of IFN, especially IFN I, are detected; this molecule blocks the viral replication in adjacent cells and produces some effects against the viral infection such as the induction of interferonstimulated gene expression, the stimulation of cytokines production, and the activation of immune response cells (i.e., macrophages, monocytes, and neutrophils) [112,114].…”

“…Interferons are molecules important to clearance the viral infection to prevent viruses from replicating [112,113]. In patients with COVID-19, high levels of IFN, especially IFN I, are detected; this molecule blocks the viral replication in adjacent cells and produces some effects against the viral infection such as the induction of interferonstimulated gene expression, the stimulation of cytokines production, and the activation of immune response cells (i.e., macrophages, monocytes, and neutrophils) [112,114]. Other CoV infections have a similar response [115,116].…”

A review on how to do hematology consults during COVID-19 pandemic

“…Neutrophils act via engulfment of microbes, secretion of anti-microbials, and formation of Neutrophil Extracellular Traps (NETs) [ 62 ]. The international research consortium termed the NETwork is working in NETs since the time of its discovery back in 2004 [ 62 , 63 ]. Since then, aberrant NET formation and subsequent NETosis activation pathway are under investigation for their possible role in NET-associated host damage, which includes the development of Acute Respiratory Distress Syndrome (ARDS), blood clots, mucous secretions in respiratory airways, and cytokine production.…”