As we all know, COVID-19 has been associated with a variety of symptoms ranging from fever, dry cough, shortness of breath, and pneumonia. The major leading cause of mortality in COVID-19 patients is respiratory failure due to acute respiratory distress syndrome (ARDS) (Amraei & Rahimi, 2020). COVID-19 induces ARDS, stimulates the immune response via cytokine storm, and causes vascular damage. Understanding the mechanisms in which COVID-19 induces endothelial injury could lead new therapeutic approaches.
Research has shown that COVID-19 seems to have more detrimental effects on patients with pre-existing conditions like hypertension, diabetes, and obesity. It is suspected that patients with these conditions experience endothelial dysfunction, which could be exacerbated when contracting COVID-19. This disease is hypothesized to be targeting angiotensin-converting enzyme2 (ACE2), which is a receptor that COVID-19 binds to for cellular entry and infection, and ultimately downregulates the expression of this receptor in the renin-angiotensin system (Amraei & Rahimi, 2020). The renin-angiotensin system plays a role in regulating blood volume and systemic vascular resistance. With a deficiency in ACE2, it is suspected that a variety of cardiovascular system complications such as increased blood pressure, endothelial dysfunction, and cardiac structural defects could be the reason why we see cardiovascular deterioration in many COVID-19 patients (Amraei & Rahimi, 2020). Some drugs such as angiotensin-converting enzyme inhibitors and angiotensin AT1 receptor blockers are being explored as a therapeutic strategy for COVID-19. ACE inhibitors are used to relax your veins and arteries and essentially lower your blood pressure. These drugs act by preventing angiotensin-II production, which normally causes narrowing of blood vessels. More research must be conducted to explore the effects of ACE inhibitors on COVID-19 patient outcomes.
With regards to COVID-19 and exploring the potential therapeutic options, there aren’t many issues concerning the four principles of biomedical ethics. The hope is that with more research and the great minds of doctors and scientists, there will be a vaccine or therapeutic option that proves to be beneficial for all and decreases the mortality rate of COVID-19, which helps to exercise the ideal beneficence and nonmaleficence.
Amraei, R., & Rahimi, N. (2020). COVID-19, Renin-Angiotensin System and Endothelial Dysfunction. Cells, 9(7), 1652. doi:10.3390/cells9071652
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