Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Can Adenosine Fight COVID-19 Acute Respiratory Distress Syndrome?

Carmela Falcone
,
Massimo Caracciolo
,
Pierpaolo Correale
,
Sebastiano Macheda
,
Eugenio Giuseppe Vadalà
,
Stefano La Scala
,
Marco Tescione
,
Roberta Danieli
,
Anna Ferrarelli
,
Maria Grazia Tarsitano
,
Lorenzo Romano
* ORCID logo ,
Antonino De Lorenzo
ORCID logo
Version 1 : Received: 17 July 2020 / Approved: 19 July 2020 / Online: 19 July 2020 (19:31:13 CEST)

How to cite: Falcone, C.; Caracciolo, M.; Correale, P.; Macheda, S.; Vadalà, E.G.; La Scala, S.; Tescione, M.; Danieli, R.; Ferrarelli, A.; Tarsitano, M.G.; Romano, L.; De Lorenzo, A. Can Adenosine Fight COVID-19 Acute Respiratory Distress Syndrome?. Preprints 2020, 2020070426. https://doi.org/10.20944/preprints202007.0426.v1 Falcone, C.; Caracciolo, M.; Correale, P.; Macheda, S.; Vadalà, E.G.; La Scala, S.; Tescione, M.; Danieli, R.; Ferrarelli, A.; Tarsitano, M.G.; Romano, L.; De Lorenzo, A. Can Adenosine Fight COVID-19 Acute Respiratory Distress Syndrome?. Preprints 2020, 2020070426. https://doi.org/10.20944/preprints202007.0426.v1

Abstract

Some COVID-19 patients develop interstitial pneumonia that can evolve into Acute Respiratory Distress Syndrome (ARDS). This is accompanied by an inflammatory cytokine storm. SarS-CoV has proteins capable of promoting cytokine storm, especially in patients with comorbidities, including obesity. Since there is currently no resolutive therapy for ARDS and given the scientific literature regarding the use of adenosine, its application has been hypothesized. Adenosine through its receptors 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 in cytokine storms. These features are known in ischemia / reperfusion models and could also be exploited in acute lung injury, with hypoxia. In light of these hypotheses, for compassionate use, a COVID-19 patient, with unresponsive respiratory failure, was treated with adenosine. The results showed a rapid and clear improvement in clinical conditions, with the negative effect of detection of SarS-CoV2.

Keywords

COVID-19; ARDS; Adenosine; CT-scan; Cytokines Storm

Subject

Medicine and Pharmacology, Anesthesiology and Pain Medicine

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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