COVID19 virus infects pulmonary endothelial cells (PECs). In addition to my previous list of drugs to prevent ARDS (1. losartan/Ramipril; 2. vitamins A and D; 3. Celebrex; 4. pioglitazone), I've found some additional drugs to try:
5. Aspirin: the D-dimers found in COVID19 indicate that platelets are activated by virally-infected PECs. Platelet activation could explain the heart attacks seen with COVID19, and the heart attacks and strokes seen with influenza A infections.
6. Omeprazole/lansoprazole/any -prazole [proton pump inhibitor] to inhibit the vacuolar proton ATPase. This pump is involved in the endosomal pathway that the COVID19 virus, influenza A, and the anthrax toxin ride into the PEC cytoplasm.
7. Another way to block the vacuolar proton pump ATPase is with Antabuse (disulfiram)!
8. Formoterol, a beta-2 agonist used in asthma, increases claudin-5 expression and strengthens tight junctions between PECs, limiting pulmonary edema.
Refs. available upon request.
For what it's worth, I'd hold off on systemic steroids, and perhaps even inhaled steroids, for as long as possible.
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