The Points of Action of Drugs for Treating COVID-19

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has reached a pandemic level. Very recently, I reported a significantly higher prevalence of diabetes and hypertension in severe COVID-19 as compared with non-severe COVID-19 by the meta-analysis. Considering that both diabetes and hypertension are risk factors for atherosclerosis, I further studied the prevalence of cardiovascular disease (CVD) in COVID-19 and found a significantly higher prevalence of CVD in severe patients than in non-severe patients. I speculate that the pre-existing vascular damage is associated with severity of COVID-19. A recent study showed that obese patients with COVID-19, despite their younger age, required more frequently assisted ventilation and access to intensive care units than normal weight patients. I thought that if the reason that COVID-19 is likely to become severe in obese people could be elucidated, the mechanism for aggravation of COVID-19 would be understood. As a result of considering a model of aggravation in obese people, I came up with the notion that pre-existing risk factors in obese people such as their vascular high-affinity for SARS-CoV-2, pro-inflammatory and pro-coagulant state and endothelial dysfunction may be likely to induce the development of “systemic severe coagulopathic vasculitis (SSCV)” in obese people. I believe that SSCV may largely contribute to the development of severe COVID-19. Here, I will describe the points of action of drugs for treating COVID-19 by using the SSCV model. J Endocrinol Metab. 2020;10(3-4):57-59 doi: https://doi.org/10.14740/jem659