Miejski Szpital Zespolony w Olsztynie, Klinika Kardiologii i Chorób Wewnętrznych, Clinic of Cardiology and Internal Medicine, Metropolitan Hospital of Nicolaus Copernicus, University of Warmia and Mazury, Niepodległości 44, 10-045, Olsztyn, Poland.
Department of Cardiac & Vascular Surgery, University Hospital of Gdańsk, M. Skłodowskiej-Curie 3a street, 80-210 Gdańsk, Poland.
Curr Hypertens Rep. 2021 Feb 27;23(2):12. doi: 10.1007/s11906-021-01130-z.
To analyze the impact of sodium retention states on the course of COVID-19 and propose possible interventions to curb disease progression.
Numerous data confirm a positive association of non-communicable diseases, aging, and other sodium-retaining states, including iatrogenic ones, with more severe sometimes fatal clinical course of COVID-19. Reasons for this effect could include increased angiotensin signaling via the AT1R receptor. The endothelial glycocalyx also plays an important role in infection, leading to a vicious cycle of inflammation and tissue sodium retention when damaged. RAS inhibitors may help restore glycocalyx function and prevent severe organ damage. Anticoagulants, especially heparin, may also have therapeutic applications due to antithrombotic, anti-inflammatory, glycocalyx-repairing, and antialdosteronic properties. The ambiguous influence of some diuretics on sodium balance was also discussed. Abnormal sodium storage and increased angiotensin-converting enzyme activity are related to the severity of COVID-19. Inducing sodium removal and reducing intake might improve outcomes.
分析钠潴留状态对 COVID-19 病程的影响，并提出可能的干预措施以抑制疾病进展。
大量数据证实，非传染性疾病、衰老和其他钠潴留状态（包括医源性钠潴留）与 COVID-19 更严重甚至有时致命的临床病程呈正相关。其原因可能包括血管紧张素 1 型受体（AT1R）介导的血管紧张素信号增加。内皮糖萼在感染中也起着重要作用，当其受损时会导致炎症和组织钠潴留的恶性循环。肾素-血管紧张素-醛固酮系统（RAS）抑制剂可能有助于恢复糖萼功能并防止严重的器官损伤。抗凝剂，尤其是肝素，由于具有抗血栓形成、抗炎、修复糖萼和抗醛固酮作用，也可能具有治疗应用。一些利尿剂对钠平衡的影响也存在争议。异常的钠储存和血管紧张素转换酶活性增加与 COVID-19 的严重程度有关。诱导钠排出和减少摄入可能会改善预后。
