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Review
. 2020 Sep 21;9(9):3045.
doi: 10.3390/jcm9093045.

Can Adenosine Fight COVID-19 Acute Respiratory Distress Syndrome?

Carmela Falcone  1 , Massimo Caracciolo  2 , Pierpaolo Correale  3 , Sebastiano Macheda  4 , Eugenio Giuseppe Vadalà  4 , Stefano La Scala  4 , Marco Tescione  4 , Roberta Danieli  5 , Anna Ferrarelli  1 , Maria Grazia Tarsitano  6 , Lorenzo Romano  7 , Antonino De Lorenzo  8
Affiliations
Review

Can Adenosine Fight COVID-19 Acute Respiratory Distress Syndrome?

Carmela Falcone et al. J Clin Med. .

Abstract

Coronavirus disease 2019 (COVID-19) patients can develop interstitial pneumonia, which, in turn, can evolve into acute respiratory distress syndrome (ARDS). This is accompanied by an inflammatory cytokine storm. severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) has proteins capable of promoting the cytokine storm, especially in patients with comorbidities, including obesity. Since currently no resolutive therapy for ARDS has been found and given the scientific literature regarding the use of adenosine, its application has been hypothesized. Through its receptors, adenosine is able to inhibit the acute inflammatory process, increase the protection capacity of the epithelial barrier, and reduce the damage due to an overactivation of the immune system, such as that occurring in cytokine storms. These features are known in ischemia/reperfusion models and could also be exploited in acute lung injury with hypoxia. Considering these hypotheses, a COVID-19 patient with unresponsive respiratory failure was treated with adenosine for compassionate use. The results showed a rapid improvement of clinical conditions, with negativity of SARS-CoV2 detection.

Keywords: ARDS; COVID-19; CT-scan; adenosine; cytokines storm.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Mechanisms of adenosine action on COVID-19.
Figure 2
Figure 2
Comparison of CT scans before and after adenosine treatment, in different sections.
See this image and copyright information in PMC

References

    1. WHO Coronavirus Disease (COVID-19) Dashboard. [(accessed on 15 July 2020)]; Available online: https://covid19.who.int/?gclid=Cj0KCQjw0rr4BRCtARIsAB0_48NF8a417ap3xz5a6....
    1. Ye Q., Wang B., Mao J. The pathogenesis and treatment of the ‘Cytokine Storm’ in COVID-19. J. Infect. 2020;80:607–613. doi: 10.1016/j.jinf.2020.03.037. - DOI - PMC - PubMed
    1. Thiel M., Choukèr A., Ohta A., Jackson E., Caldwell C.C., Smith P., Lukashev D., Bittmann I., Sitkovsky M.V. Oxygenation Inhibits the Physiological Tissue-Protecting Mechanism and Thereby Exacerbates Acute Inflammatory Lung Injury. PLoS Boil. 2005;3:e174. doi: 10.1371/journal.pbio.0030174. - DOI - PMC - PubMed
    1. Tay M.Z., Poh C.M., Rénia L., Macary P.A., Ng L.F.P. The trinity of COVID-19: Immunity, inflammation and intervention. Nat. Rev. Immunol. 2020;20:363–374. doi: 10.1038/s41577-020-0311-8. - DOI - PMC - PubMed
    1. Gorbalenya A.E., Coronaviridae Study Group of the International Committee on Taxonomy of Viruses The species Severe acute respiratory syndrome-related coronavirus: Classifying 2019-nCoV and naming it SARS-CoV-2. Nat. Microbiol. 2020;5:536–544. doi: 10.1038/s41564-020-0695-z. - DOI - PMC - PubMed

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