COVID-19, Angiotensin Receptor Blockers, and the Brain
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EDITORIAL
COVID‑19, Angiotensin Receptor Blockers, and the Brain Juan M. Saavedra1 Received: 8 April 2020 / Accepted: 2 May 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
The abundant scientific information on the COVID-19 pandemic we receive through academic publications and correspondence, as well as through social media, is sometimes preliminary, incomplete, and contradictory. For this reason, it is dangerous to rush to interpret those early results. This could backfire and unwittingly feed a mistrust of the stringent scientific method. While fast dissemination of information in the form of commentaries and publications without prior review by experts has its merits in this state of emergency, erroneous results and recommendations find their way to the general population, frequently without the expertise to accurately assess the information presented. In this time of uncertainty and fear, it is difficult to remain objective and to critically evaluate the scientific merit of the available new information. The peer review system by experts has been and needs to continue to be a pillar of scientific progress. It is important to point out that information from well-regarded previously published peer-reviewed publications on previously known Severe Acute Respiratory Syndrome (SARS) coronavirus is used as the basis to further explore the SARS-CoV-2 mechanisms of infection and to search for novel therapies. This Editorial intends to highlight recent reports of neurological complications of COVID-19, to describe the pleiotropic protective properties of Angiotensin Receptor Blockers (ARBs) in multiple organs including the brain and the lung, to clarify contradictory recommendations regarding the present use of ARBs in patients affected with cardiovascular and other illnesses that may later become COVID-19 comorbidities, to describe the complexities of ACE2 on its dual role of SARS-CoV-2 receptor and as a major protective mechanism in lung injury, and to suggest future studies necessary to definitively determine the potential therapeutic value of ARB treatment in COVID-19 patients. * Juan M. Saavedra [email protected] 1
Department of Pharmacology and Physiology, Georgetown University Medical Center, 3900 Reservoir Road, NW, Washington, DC 20057, USA
SARS‑CoV‑2 Injures the Brain The SARS-CoV-2, responsible for the current coronavirus disease COVID-19, not only affects the lung but also targets the nervous system. SARS-CoV-2 may reach the brainstem through a neural route from lung chemoreceptors, severely affecting the cardiorespiratory center (Li et al. 2020a). This suggests that the acute respiratory failure in some COVID-19 patients may have a central origin (Li et al. 2020a). SARS-CoV-2 may also injure olfactory nerve terminals in the nasal cavity, explaining both the anecdotal and the recently published observations of associated decreased sense of smell in COVID-19 patients (Yeager 2020a; Rabin 2020; Lechien et al. 2020). It is of note that olfactory deficits have been pre
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