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Abstract
Despite the burden of disease of CVD and DM, there is a lack of experimentally validated literature exploring their association with exacerbation of COVID-19. Target receptors of medications commonly used to treat CVD and DM may be involved in the viral entry mechanism of SARS-CoV-2. We propose the potential protective effects of these medications in COVID-19 infections, highlighting the need for further research. Firstly, AMPK mediated phosphorylation of ACE-2 by metformin as well as the drug’s alkaline properties may interrupt the natural disease progression. Secondly, DPP4 receptor involvement in the putative viral entry of SARS-CoV-2 may be prevented by DPP4i. Finally, recent studies have shown that statins’ ability to inhibit the cytokine storm may outweigh concerns of statin mediated ACE-2 upregulation in COVID-19. The complex interplay of factors affecting CVD and DM in COVID-19 patients makes the direct effects of medications difficult to examine. Therefore, further research is needed, in the context of SARS-CoV-2 and the molecular pathways it exploits, to potentially repurpose such pre-existing drugs for their use in COVID-19.
Highlights
Despite the burden of disease of cardiovascular disease (CVD) and diabetes mellitus (DM), there is a lack of experimentally validated literature exploring their association with exacerbation of COVID-19
The literature surrounding the association between cardiovascular disease (CVD) and diabetes mellitus (DM) with SARSCoV-2 is sparse
There are two aspects pertaining to CVD; firstly, the concept that SARS-CoV-2 can propagate the development of CVD, and secondly, preexisting CVD can exacerbate SARS-CoV-2 infections, increasing the incidence of cardiac complications
Summary
Despite the burden of disease of CVD and DM, there is a lack of experimentally validated literature exploring their association with exacerbation of COVID-19. That patients with these common comorbidities are likely on medications, which may offer protection against severe infections. It is crucial to identify interactions of SARS-CoV-2 with commonly used drugs, including metformin, dipeptidyl-peptidase 4 inhibitors (DPP4i) and statins, with the potential to repurpose them to prevent disease progression.
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