Title:Administration of Exogenous Surfactant and Cytosolic Phospholipase A2α Inhibitors may Help COVID-19 Infected Patients with Chronic Diseases
Volume: 2
Issue: 12
Author(s): Mohammed Abdalla Hussein*
Affiliation:
- Department of Biochemistry, Faculty of Applied Medical Sciences, Octoberth 6University, Sixth of October City,Egypt
Keywords:
COVID-19 pandemic, phosphatidylglycerol, pulmonary surfactant, chronic diseases, cytosolic phospholipase A2αand exogenous phospholipid surfactant.
Abstract: Background: Coronavirus-19 (COVID-19) pandemic is a worldwide public health
problem causing 347,070 deaths from December 25, 2019, till May 25, 2020. Phospholipids are
structural components of mammalian cytoskeleton and cell membranes. Phosphatidylglycerol is an
anionic lipid found in mammalian membranes in low amounts (1-2%) of the total phospholipids.
Also, phosphatidylglycerol suppresses viral attachment to the plasma membrane and subsequent replication
in lung cells. Phosphatidylglycerol depletion caused by over expression of cytosolic phospholipase
A2α induces lipid accumulation in lung alveoli and promotes acute respiratory distress
syndrome (ARDS). An exogenous-surfactant replacement has been successfully achieved in ARDS
and improved oxygenation and lung mechanics. Inhibition of cytosolic phospholipase A2alpha impairs
an early step of COVID-19 replication.
Aim: The present study was carried out to explain the correlation between the administration of exogenous
artificial surfactant as well as cytosolic phospholipase A2α inhibitors to improve oxygenation
and lung mechanics and inhibit COVID-19 replication.
Methods: Database research was carried out on Medline, Embase, Cochrane Library, country-specific
journals, and following-up WHO reports published between December 25, 2019 - May 25,
2020.
Results: Till 25 May 2020, coronavirus cases were 5,307,298, with 347,070 deathsand 2,314,849
recovered cases. According to the WHO reports, most COVID-19 deaths seen are in people who
suffered from other chronic diseases characterized by phospholipidosis and phosphatidylglycerol
deficiency, including hypertension, liver, heart, and lung diseases and diabetes. Phospholipases A2
(PLA2) catalyze the cleavage of fatty acids esterified at the sn-2 position of glycerophospholipids
leading to enhanced inflammation and lung damage. Also, cytosolic phospholipase A2α inhibitors
may reduce the accumulation of viral proteins and RNA. In addition, administration of exogenous
phospholipid surfactant may help COVID-19 infected patients with ARDS to remove inflammatory
mediators.
Conclusion: The present study showed a relation between phosphatidylglycerol deficiency in
COVID-19 infected patients with ARDS and/or chronic diseases and their mortality. These findings
also showed an important approach for the prevention and treatment of COVID-19 infections
by using cytosolic phospholipase A2α inhibitors and exogenous administration of a specific phospholipid
surfactant.
