Paolo Lissoni, Giorgio Porro, Giusy Messina, Giuseppe Di Fede, Alberto Caddeo
It has been shown that the link of Covid19 spike protein to ACE2 receptors does not allow only the entry of virus into the cells, but also a reduced ACE2 functions, with a following diminished production of its main product, Ang 1-7, which has appeared to play a fundamental anti-inflammatory role. In more detail, Ang 1-7 has been shown to inhibit the secretion of the main inflammatory cytokines, including IL-17, IL-6 and TNF-alpha, which are responsible for Covid19 infection-related respiratory distress and thromboembolic events. Ang 1-7 deficiency could explain at least in part the persistence of some cardiopulmonary and neurological disfunctions, which constitute the post-Covid19 syndrome. Other two fundamental neuroendocrine systems involved in the control of the inflammatory response are represented by brain endocannabinoid system and the pineal gland through its most studied hormone, melatonin (MLT). Because of the complete lack of therapeutic indications in the treatment of the post-Covid19 infection syndrome, on these bases a study was planned with Ang 1-7, MLT and cannabidiol (CBD) in patients with post-Covid19 persistent asthenia and other symptoms. The study included 14 patients. All drugs were orally administered. Ang 1-7 was given at 0.5 mg twice/day, MLT at 50 mg/once day in the night, and CBD at 10 mg twice/day. An evident relief was reached within the first week of therapy in 12/14 (86%). An improvement of dyspnoea was also obtained in 3/4 (75%) patients. Finally, myalgia, neuropathy, and mood also improved, while the diminished taste perception persisted for a longer time. This preliminary results would suggest that a neuroendocrine regimen carried out to correct possible Covid19 infection-induced Ang 1-7-pineal and cannabinoid deficiencies, may improve the symptomatology of post-Covid19 syndrome.
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