Some studies have suggested that airway epithelial expression of ACE2 is dynamic and associated with cellular differentiation, a finding that may underlie susceptibility to infection. The apical expression of ACE2 on epithelia indicates that this coronavirus receptor is accessible for topical application of receptor antagonists or inhibitors. Albeit there is a trend going towards to the opposite direction in terms of attitude pro/con ARB/ACEi use in Covid-19, I wonder if a topical formulation of ie valsartan may have a rationale, at the least at an early stage of the disease, combined with other antiviral.
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