We know that COVID-19 does not affect all population groups equally. Those with previous pathologies that weaken their immune system or with respiratory diseases are more likely to suffer serious complications. This notion was well known to experts since the beginning of the coronavirus outbreak. Since January, two hundred scientific publications have seen the light, which shows the enormous effort of scientists to understand more and more details about the pandemic.
Research areas that focus not only on comorbidities, but also on the confluence of drugs with SARS-CoV-2 infection are pioneering. Studies have been done on drugs such as ibuprofen, the results of which are inconclusive; Now an article published in the Journal of Clinical Endocrinology & Metabolism has come to the following conclusion: “People who take a class of steroid hormones, called glucocorticoids, for conditions like asthma, allergies and arthritis on a routine basis may not being able to generate a normal response to stress and are at high risk if they are infected with the virus that causes COVID-19 “ , quotes the statement, issued by the Endocrinology Society.
Glucocorticoids are used to treat a variety of inflammatory conditions and are administered by many routes: pills, creams, and inhalers. The new findings suggest that patients taking these drugs may be more susceptible to COVID-19 as a result of the suppression of the immune system and also because the drugs suppress their own steroid response to infection. The statement also indicates that people with known primary adrenal insufficiency, also known as Addison’s disease, and secondary adrenal insufficiency , who are undergoing treatments of this type and who may be infected with the coronavirus should also take additional precautions. .
Investigators have drawn on previous experience in patients with acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), where glucocorticoid therapy had no benefit or was associated with higher rates of invasive ventilation and mortality. Therefore, this treatment would be contraindicated by the World Health Organization for patients with COVID-19.
In addition, the study also indicates that, for patients with diabetes, the severity of the disease from viral infections is also markedly greater. In reports published in Wuhan they revealed that people with diabetes mellitus and hypertension were overrepresented among the most severely ill COVID-19 patients and also among those who succumbed to the disease.
Regarding hypertensive patients, other studies have suggested that receptors that ‘fit’ with the virus and help it enter human cells (ACE2 inhibitors) could increase susceptibility and severity to COVID-19 through positive regulation of ACE2. That would explain the overrepresentation of hypertensive patients in patients who die from COVID-19.
Attention: abandoning a treatment has risks
However, it is advisable not to be alarmed about the use of these drugs, since in the event that patients abandon treatment, the consequences could be much worse for their health. In the words of the doctor in Pharmacy Marián (Apothecary) García: “If hypertensive or asthmatic people abandon their medication for fear of complications from a respiratory disease that they do not yet have, the consequences for them could be dire.”
We have to understand that, for now, these publications are inquiries that scientists are making little by little, and it is early to advise against drugs that are necessary to treat other pathologies , especially if the patient in question does not have COVID-19 or does not have the you suspect you may have it.
Scientists have already helped discover how the virus responsible for COVID-19 enters cells and spreads from one individual to another. Some have already made preliminary observations regarding the interactions of the virus with the endocrine system. In any event, endocrinology-related goals are at the forefront of discovery science as we collectively address this pandemic.
Referencia:
Ursula B Kaiser et al. ‘Our Response to COVID-19 as Endocrinologists and Diabetologists’, The Journal of Clinical Endocrinology & Metabolism (2020). DOI: 10.1210/clinem/dgaa148
