Cite this asAbd EE (2020) Impact of coronavirus pandemic on cancer patients; is it time for ectoine and/or ACE inhibitors? J Gynecol Res Obstet 6(1): 002-003. DOI: 10.17352/jgro.000075
Cancer patients require attention after COVID-19. ACEI and/or ectoine could represent potential adjuvant therapy. Clinical trials are required to investigate this hope to mitigate COVID-19 infectivity and cell invasion.
In 2018, globocan reported 18,078,957 new cancer cases and 9,555,027 total deaths from cancer worldwide . During coronavirus pandemic (total confirmed cases 191,127 and 7,807 of total deaths, globally; situation report-58), it is crucial to pay attention to immunosuppressed cancer patients especially, who are on recent active treatment. Qin, et al. , reported immune dysregulation in COVID-19 affected patients. Analysis of 2007 confirmed COVID-19 cases from 575 Chinese hospitals revealed that patients with cancer (18 patients) deteriorated more rapidly than those without cancer (13 days versus 43 days; p < 0.0001) . Cancer patients had elder age, smoking history, abnormality in CT-scan, and polypnea. Risk factors for sever events in COVID-19 patients included age, female gender, cancer, hypertension, COPD, and diabetes mellitus .
ACE-2 receptor and serine protease TMPRSS2 are detrimental for infectivity of COVID-19 [4,5]. Thus camostat, and ACEI were suggested as possible potential treatments for COVID-19 . Additionally, based on the molecular biology of the virus, Cepharanthine (CEP), selamectin and mefloquine hydrochloride were suggested as potential therapeutics for COVID-19 . However, ACEI and angiotensin receptor blockers were hypothesized to modulate sever effects of COVID-19 and raised more concerns or patients with other comorbidities [6,7].
Minimal invasive autopsy of three COVID-19 cases revealed significant inflammatory response in lungs and tissue damage in other organs including heart, liver and kidney . Tian, et al. , also reported inflammatory lung response in two cases who underwent lung lobectomies for adenocarcinoma. Ectoine, a compatible Solute with no detectable cytotoxicity so far, proven to modulate the inflammatory response in lungs [10-13] and would prove potential adjuvant therapy for COVID-19.
Contradictory results were obtained from testing ACEI in oncology while no toxicity and promising results were achieved using ectoine. Clinical trials are required to test the validity of these drugs to attenuate the COVID-19 sever events.
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