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A paradigm shift in the role of NSAIDs in COVID-19: new pathological mechanisms and potential treatment targets

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Ilie P. C., Stefanescu S., Veronese N.
Atena Journal of Public Health
|
2020
|
vol. 2
6-6
EN
Objectives: The pathogeny of SARS-COV2 infection is currently not well defined. In this paper, we present a new perspective of how the SARS-CoV2 infection can lead to severe cases and potential pathways of preventing such cases. Methods: In the first part, we describe the role of cyclooxigenase 2 and in the second part, we describe the role of hypoxia inducible factor (HIF). Findings: We hypothesize that cyclooxigenase 2 and hypoxia inducible factor with subsequent inflammation and hypoxia can up-regulate each other in a vicious circle of feed-forward that can ultimately lead to “cytokine storm”. Conclusions: Breaking this cycle early potentially will have beneficial effects either by improving oxygenation (oxygen being given earlier in the course of the treatment) or by inhibiting COX-2. We also believe, that the use of COX-2 inhibitors early in the course of the disease can improve the outcome and clinical trial are urgently needed. 
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