by António Tralhão, Luís Ferreira Moita and Pedro Póvoa
Critical Care volume 24,
Article number: 324 (2020)
The severe acute respiratory syndrome coronavirus 2
(SARS-CoV-2) and its associated coronavirus disease 2019 (COVID-19) have
wreaked havoc on healthcare systems globally. The potential for spread of this
highly infectious virus, which is more transmissible and lethal than influenza,
has reached pandemic proportions and has left many clinicians scrambling to
provide care with scarce resources, all in the setting of no curative treatment,
immunization, or effective therapy. Some candidate therapies include antivirals
(remdesivir), antimalarials (hydroxychloroquine), and vaccines (mRNA-1273).
Moreover, as we learn more about this virus, we have begun to draw some
noteworthy conclusions regarding currently available ancillary “therapies”
which may affect the natural history of the COVID-19 infection. Some of these
“therapies” may actually be the avoidance of certain medications, like
ibuprofen. Likewise, patients on angiotensin-converting enzyme (ACE) inhibitors
or angiotensin receptor blockers (ARB) could be at a greater risk due to the
mechanism by which SARS-CoV-2 enters the cell. It stands to reason that
therapeutics that act counter to this mechanism may confer protection.
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