Is carbonic anhydrase inhibition useful as a complementary therapy of Covid-19 infection?

J Enzyme Inhib Med Chem. 2021 Dec;36(1):1230-1235. doi: 10.1080/14756366.2021.1924165.

Abstract

The ongoing Covid-19 is a contagious disease, and it is characterised by different symptoms such as fever, cough, and shortness of breath. Rising concerns about Covid-19 have severely affected the healthcare system in all countries as the Covid-19 outbreak has developed at a rapid rate all around the globe. Intriguing, a clinically used drug, acetazolamide (a specific inhibitor of carbonic anhydrase, CA, EC 4.2.1.1), is used to treat high-altitude pulmonary oedema (HAPE), showing a high degree of clinical similarities with the pulmonary disease caused by Covid-19. In this context, this preliminary study aims to provide insights into some factors affecting the Covid-19 patients, such as hypoxaemia, hypoxia as well as the blood CA activity. We hypothesise that patients with Covid-19 problems could show a dysregulated acid-base status influenced by CA activity. These preliminary results suggest that the use of CA inhibitors as a pharmacological treatment for Covid-19 may be beneficial.

Keywords: CO2; Covid-19; carbonic anhydrase; high-altitude pulmonary oedema; hypoxia.

MeSH terms

  • Acetazolamide / therapeutic use*
  • Acid-Base Equilibrium / drug effects
  • Altitude Sickness / blood
  • Altitude Sickness / drug therapy
  • Anticonvulsants / therapeutic use
  • Antiviral Agents / therapeutic use*
  • Bicarbonates / blood
  • COVID-19 / blood
  • COVID-19 / diagnostic imaging
  • COVID-19 / virology
  • COVID-19 Drug Treatment*
  • Carbon Dioxide / blood
  • Carbonic Anhydrase Inhibitors / therapeutic use*
  • Carbonic Anhydrases / blood*
  • Cough / blood
  • Cough / drug therapy
  • Cough / pathology
  • Cough / virology
  • Drug Repositioning
  • Dyspnea / blood
  • Dyspnea / drug therapy
  • Dyspnea / pathology
  • Dyspnea / virology
  • Fever / blood
  • Fever / drug therapy
  • Fever / pathology
  • Fever / virology
  • Humans
  • Hydrogen-Ion Concentration
  • Hypertension, Pulmonary / blood
  • Hypertension, Pulmonary / drug therapy
  • Hypoxia / blood
  • Hypoxia / drug therapy
  • Hypoxia / pathology
  • Hypoxia / virology
  • Oximetry
  • Research Design
  • SARS-CoV-2 / pathogenicity
  • SARS-CoV-2 / physiology
  • Severity of Illness Index
  • Tomography, X-Ray Computed

Substances

  • Anticonvulsants
  • Antiviral Agents
  • Bicarbonates
  • Carbonic Anhydrase Inhibitors
  • Carbon Dioxide
  • Carbonic Anhydrases
  • Acetazolamide

Supplementary concepts

  • Pulmonary edema of mountaineers