Modulating inflammation in COVID-19 viral disease: The emerging role for dexamethasone

Abstract

Background: The global scientific community continues to saddle one of the responsibilities of constraining the menace caused by Coronavirus Disease 2019 (COVID-19); a relatively novel corona virus infection that has metamorphosed to becoming a pandemic. Epidemiological evidence shows that it is responsible for over 1.7 million death worldwide. Besides, the pandemic has negatively impacted vital sectors of national economy and government such as employment of labor, transportation, national budgets and financial business progression. Conversely, the times have driven scientists, medical experts and health professionals to thinking up newer and safer therapeutic strategies in order to better manage and combat the virus. While several therapeutic approaches have been unveiled by researchers, this article lays emphasis on modulating inflammation in COVID-19 viral disease with respect to an emerging role for dexamethasone. Crosstalk between pathogenesis of Severe Acute Respiratory Syndrome-related Coronavirus-2 (SARSr-CoV-2) and inflammation remains invaluable to unraveling other alternative drug targets that may pose as probable paths towards mitigating the effects of the virus in humans.

Methods: The roles of angiotensin converting enzyme-2 protein in mediating the transfer of SARSr-CoV-2 into epithelial cells of the mucosal membranes of the conjunctiva and oral cavity was evaluated. Also, viral antigen presentation in the cells was evaluated as a trigger to an immunological reaction that results in a cytokine surge in the blood, downplay of lymphocytic cells and upregulation of other chemical mediators of inflammation. This eventually actuates the hemostatic system to trigger pro coagulating factors and thrombo-inflammatory responses, which may ultimately lead to fibrosis and other respiratory disorders.

Conclusion: The ameliorative effect of dexamethasone, a commonly used glucocorticoid for treating inflammatory disorders remains striking and significant in SARSr-CoV-2 management. Contrary to data gotten from previous studies of glucocorticoids effect on earlier existing corona viruses, recent findings have reported that dexamethasone possess some beneficial effects in attenuating pulmonary derangements caused by SARSr-CoV-2. Moreover, this brings to limelight and further buttresses the relationship between inflammation and COVID-19 pathology. Hence, the need to discover newer or repurpose preexisting drug molecules that may target inflammatory signaling cascades in COVID-19mviral disease is imperative.