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锌补充剂对心血管疾病和 COVID-19 合并症的可能益处。

Possible Benefits of Zinc supplement in CVD and COVID-19 Comorbidity.

机构信息

Department of Microbiology, University of Dhaka, Dhaka 1000, Bangladesh.

Institute of National Analytical Research and Service (INARS), Bangladesh Council of Scientific and Industrial Research (BCSIR), New Elephant Road, Dhaka 1205, Bangladesh.

出版信息

J Infect Public Health. 2021 Nov;14(11):1686-1692. doi: 10.1016/j.jiph.2021.09.022. Epub 2021 Oct 4.

Abstract

As far as comorbidity is concerned, cardiovascular diseases (CVD) appear to be accounted for the highest prevalence, severity, and fatality among COVID 19 patients. A wide array of causal links connecting CVD and COVID-19 baffle the overall prognosis as well as the efficacy of the given therapeutic interventions. At the centre of this puzzle lies ACE2 that works as a receptor for the SARS-CoV-2, and functional expression of which is also needed to minimize vasoconstriction otherwise would lead to high blood pressure. Furthermore, SARS-CoV-2 infection seems to reduce the functional expression of ACE2. Given these circumstances, it might be advisable to consider a treatment plan for COVID-19 patients with CVD in an approach that would neither aggravate the vasodeleterious arm of the renin-angiotensinogen-aldosterone system (RAAS) nor compromise the vasoprotective arm of RAAS but is effective to minimize or if possible, inhibit the viral replication. Given the immune modulatory role of Zn in both CVD and COVID-19 pathogenesis, zinc supplement to the selective treatment plan for CVD and COVID-19 comorbid conditions, to be decided by the clinicians depending on the cardiovascular conditions of the patients, might greatly improve the therapeutic outcome. Notably, ACE2 is a zinc metalloenzyme and zinc is also known to inhibit viral replication.

摘要

就合并症而言,心血管疾病 (CVD) 在 COVID-19 患者中似乎具有最高的患病率、严重程度和死亡率。大量将 CVD 和 COVID-19 联系起来的因果关系使整体预后和既定治疗干预的效果变得复杂。这个谜团的核心是 ACE2,它是 SARS-CoV-2 的受体,需要其功能性表达来最小化血管收缩,否则会导致高血压。此外,SARS-CoV-2 感染似乎会降低 ACE2 的功能性表达。在这种情况下,对于患有 CVD 的 COVID-19 患者,考虑一种治疗方案可能是明智的,该方案既不会加重肾素-血管紧张素-醛固酮系统 (RAAS) 的血管损伤臂,也不会损害 RAAS 的血管保护臂,但又能有效最小化或尽可能抑制病毒复制。鉴于锌在 CVD 和 COVID-19 发病机制中的免疫调节作用,根据患者的心血管状况,由临床医生决定向 CVD 和 COVID-19 合并症的选择性治疗方案中添加锌补充剂,可能会极大地改善治疗效果。值得注意的是,ACE2 是一种锌金属酶,锌也已知可抑制病毒复制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac9c/8489295/521278208892/gr1_lrg.jpg

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