Studies have found that more than 14% to 33% of patients who have contracted COVID-19 infection experience severe illness. Among them, two-thirds develop Acute Respiratory Distress Syndrome or ARDS.
Acute respiratory distress syndrome is a condition where lung tissues are damaged because of inflammation and the collection of fluid in the lung’s air sacs also known as alveoli, which functions as a gas exchanger with blood vessels.
A Common Drug Of Hypertension May Treat Severe Cases Of COVID-19
When blood vessels leak, fluids are accumulated in alveoli, which restricts the ability of the lungs to supply the whole body with oxygen. And thus, acute respiratory distress syndrome requires intensive care unit admission and possibly mechanical ventilation.
Gradually becoming the major death cause in COVID-19, ARDS also doesn’t have any treatments available.
A study appeared in the Journal of the American College of Cardiology which states that an oral tablet known as metoprolol can improve functions of respiration by reducing inflammation in the lungs in patients suffering from ARDS induced by COVID-19. Metoprolol is made to treat high blood pressure and is a beta-blocker. It may give cheap treatment for severe cases of COVID-19.
The COVID-19 infection stimulates a response from the immune system that restricts disease progression.
In some severe COVID-19 cases, excessive and unrestrained stimulation of the immune system can take place against the speedily multiplying virus, causing complications like ARDS and organ failure.
The primary tissue damage that occurs by the COVID-19 infection leads to the manufacturing of cytokines, which are molecules that give signals. Other molecules along with cytokines discharged from the damaged tissues send immune cells to the lungs like macrophages and neutrophils.
Also known as cytokine storm, excess manufacturing of cytokines and alarming state of macrophages and neutrophils are the major signs of ARDS induced by COVID-19 infection
After the stimulated macrophages and neutrophils are sent to the lungs, they make cytokine themselves leading to a cytokine storm.
As seen in ARDS, stimulated neutrophils to help protect the body against the virus; its overstimulation damages blood vessels and lung tissues. The number of neutrophils in the lungs match up to the rate of the severity of COVID-19 and can be a sign of major complications.
Beta-blocker drugs restrict the effects of epinephrine and norepinephrine hormones’ flight or fight response. These are majorly used to treat cardiovascular conditions.
A professor at the Norway’s University of Oslo, Dr. Sverre Kjeldsen, who was not involved in the study, said that patients suffering from severe COVID-19 are under huge stress and their bodies activate a very powerful sympathetic nervous system. Kjeldsen said that when excessive amounts of adrenaline and noradrenaline are released, they damage every organ and even the lungs. And when it is treated by the beta-blocker, it eases up the damage.
The Centro Nacional de Investigaciones Cardiovasculares Carlos’s led team of researchers showed that metoprolol helps in reduction in inflammation of the lungs and improve levels of blood oxygen.
The team of researchers concluded that metoprolol lessens the count of neutrophils in the lungs which leads to reduced neutrophil activation levels.
The first author of the study, Agustin Clemente-Moragon said that their Spanish National Centre for Cardiovascular Research’s group, in the last few years, has found knowledge in the beta-blockers unique and disruptive role against inflammatory responses due to neutrophils.
Agustin said that these data from various experiments pushed them to study the pilot trial of MADRID-COVID. They wanted to find if the administration of intravenous metoprolol could bring promising results in individuals with ARDS induced by COVID-19.
The general director of CNIC and the study’s co-author, Dr. Valentin Fuster, said that the study’s significance is that if they prove to be correct, the new approach will be very affordable and cheap.