Causton Helen C
Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, NY, United States.
Front Med (Lausanne). 2021 Oct 27;8:744697. doi: 10.3389/fmed.2021.744697. eCollection 2021.
SARS-CoV2 infection results in a range of symptoms from mild pneumonia to cardiac arrhythmias, hyperactivation of the immune response, systemic organ failure and death. However, the mechanism of action has been hard to establish. Analysis of symptoms associated with COVID-19, the activity of repurposed drugs associated with lower death rates or antiviral activity and a small number of studies describing interventions, point to the importance of electrolyte, and particularly potassium, homeostasis at both the cellular, and systemic level. Elevated urinary loss of potassium is associated with disease severity, and the response to electrolyte replenishment correlates with progression toward recovery. These findings suggest possible diagnostic opportunities and therapeutic interventions. They provide insights into comorbidities and mechanisms associated with infection by SARS-CoV2 and other RNA viruses that target the ACE2 receptor, and/or activate cytokine-mediated immune responses in a potassium-dependent manner.
严重急性呼吸综合征冠状病毒2（SARS-CoV2）感染会导致一系列症状，从轻度肺炎到心律失常、免疫反应过度激活、全身器官衰竭乃至死亡。然而，其作用机制一直难以确定。对与2019冠状病毒病（COVID-19）相关症状的分析、与较低死亡率或抗病毒活性相关的 repurposed 药物的活性，以及少数描述干预措施的研究，都表明电解质，尤其是钾离子，在细胞和全身水平的内稳态具有重要意义。尿钾流失增加与疾病严重程度相关，而电解质补充的反应与康复进程相关。这些发现提示了可能的诊断机会和治疗干预措施。它们为与SARS-CoV2及其他靶向血管紧张素转换酶2（ACE2）受体和/或以钾离子依赖方式激活细胞因子介导的免疫反应的RNA病毒感染相关的合并症和机制提供了见解。
