HomeLifestyleHealth & FitnessThis condition worsens SARS-CoV-2 infection and disease severity

This condition worsens SARS-CoV-2 infection and disease severity

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More than 4.6 million people have died as a result of the ongoing coronavirus disease 2019 (COVID-19) pandemic, which is caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

This condition causes a wide range of symptoms that include respiratory, neurological, and digestive issues. Some COVID-19 individuals who are highly infected have acute pneumonia, while others experience gastrointestinal (GI) symptoms such as diarrhoea, vomiting, and so on.

According to a new study published in the journal Frontiers of Medicine, Barrett’s oesophagus (BE) and gastroesophageal reflux disease (GERD) could be new complications linked to SARS-CoV-2 infection. A recent study estimated that 5.6 percent of individuals in the United States have BE, a disease in which the oesophagus squamous mucosa is destroyed by GERD.

The findings revealed that ACE2 is strongly expressed in the oesophagus of BE patients. The acid pH promotes the expression of ACE2 in these patients. The researchers cultivated human primary monocytes in low pH, which resulted in increased ACE2 expression and a higher viral load after SARS-CoV-2 infection.

According to the researchers, acid pH promotes COVID-19 infection by up-regulating the ACE2 receptor, which could have clinical consequences for people suffering from GERD or BE. Although there is no evidence of a link between pH changes and ACE2 expression, earlier research has demonstrated that hypoxic environments can enhance ACE2 expression.

This study discovered that two recognized ACE2 regulators, HNF1B and FOXA2, were shown to be up-regulated in six out of eight BE transcriptome analyses. This suggests that these regulators may be involved in the pH-induced ACE2 expression in BE.

One of the most prominent aspects of COVID-19 disease is pulmonary damage, which can result in acute hypoxia and various forms of respiratory acidosis. Furthermore, experts suspect that blood acidity occurs in some of the severely infected COVID-19 individuals.

This condition worsens the patient’s condition by boosting ACE2 expression, which facilitates SARS-CoV-2 entrance into human cells. A high amount of the lactate dehydrogenase enzyme, which converts lactate from pyruvate, has also been related to severe COVID-19 disease.

This elevated lactate level may directly affect extracellular and intracellular pH, which in turn affects ACE2 expression. More research is needed to determine how acute systemic acidosis affects COVID-19 severity.

According to the findings of this investigation, pH alone may be able to affect ACE2 expression and, as a result, prevent SARS-CoV-2 infection in patients.

This study comprised 1,357 SARS-CoV-2 infected individuals from two separate cohorts. One group had a history of taking proton pump inhibitors (PPI), while the other had never used the medicine. This study discovered that patients taking PPI (used to treat GERD) had a higher risk of developing severe SARS-CoV-2 infection. This was determined by observing an increase in the number of intensive care admissions.

Furthermore, the researchers discovered that the rate of mortality increased 2- to 3-fold in the PPI-treated group compared to the non-PPI-treated group. This finding is consistent with prior research, which found that PPIs increased the chance of progression to severe COVID-19. A previous study found that people who took PPI had a higher risk of contracting COVID-19, possibly because PPI lowered the stomach barrier to SARS-CoV-2.

The authors of this study feel that pH has a significant impact on SARS-CoV-2 infection and disease severity. More research with bigger cohorts is needed to validate this finding and establish the molecular mechanism underlying pH-induced ACE2 expression.

Image Credit: Getty

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