Mechanisms of COVID-19 Entry into the Cell: Potential Therapeutic Approaches Based on Virus Entry Inhibition in COVID-19 Patients with Underlying Diseases.

Affiliation

Musavi H(1), Abazari O(2), Safaee MS(3), Variji A(4), Koohshekan B(5), Kalaki-Jouybari F(6), Barartabar Z(7), Hakemi P(8), Mahjoub S(9).
Author information:
(1)Department of Clinical Biochemistry, School of Medicine, Babol University of Medical Sciences, Babol, Iran. [Email]
(2)Department of Clinical Biochemistry, School of Medicine, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran. [Email]
(3)Department of Biology, Faculty of Biology Sciences, Islamic Azad University, North Tehran Branch, Tehran, Iran. [Email]
(4)Department of Clinical Biochemistry, Faculty of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran. [Email]
(5)Department of Clinical Biochemistry, Faculty of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran. [Email]
(6)Department of Clinical Biochemistry, School of Medicine, Babol University of Medical Sciences, Babol, Iran. [Email]
(7)Department of Clinical Biochemistry, School of Medicine, Hamedan University of Medical Sciences, Hamedan, Iran. [Email]
(8)Department of Chemical Engineering, Islamic Azad University, Ayatollah Amoli Branch, Amol, Iran. [Email]
(9)Department of Clinical Biochemistry, School of Medicine, Babol University of Medical Sciences, Babol, Iran AND Cellular, and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran AND Department of Pathology, University of Kiel, Kiel, Germany. [Email]

Abstract

The Coronavirus disease 2019 (COVID-19) virus spread from Wuhan, China, in 2019 and is spreading rapidly around the world. COVID-19 victims are almost associated with cardiovascular disease, high blood pressure, diabetes, and other underlying diseases. Concerning the high prevalence of these disorders, widespread mortality threatens global society, and its fatality rate may increase with increasing COVID-19 prevalence in countries with older populations. Therefore, evaluating patients' clinical status with severe COVID-19 infection and their medical history can help manage treatment. Currently, one of the considered treatments is angiotensin-converting enzyme 2 (ACE2) inhibition. This study investigated virus entry mechanisms through membrane receptors, their role in the pathogenesis of COVID-19 and underlying diseases, and treatment methods based on the viral entrance inhibition. According to existing studies, inhibition of ACE2 can increase oxidative stress, inflammation, fibrosis and ultimately exacerbate underlying diseases such as cardiovascular disease, kidney disease, diabetes, and hypertension in individuals with COVID-19. The ACE2 inhibition is not suitable for patients with COVID-19 with underlying diseases, but it seems that the recombinant ACE2 solution is more appropriate for inhibiting the virus in these patients if hypotension would be monitored.