Guest Editorial
Volume 6 Issue 6 - 2020
A Suggestion on Ethanol Therapy in COVID-19?
Ali Amoushahi1* and Annemarie Padmos2
1Anesthesiology and Intensive Care Department, Isabne Maryam Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
2MSc student, Master of Advanced Nursing Practice at Rotterdam University of Applied Sciences, Rotterdam University of Applied Sciences, Netherlands
*Corresponding Author: Ali Amoushahi, Anesthesiology and Intensive Care Department, Isabne Maryam Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
Received: April 28, 2020; Published: May 25, 2020




The world emergence pandemy of respiratory disease caused by new coronavirus named COVID-19 is a viral disease that may cause cytokine storm condition [1,2]. To overcome this fatal emerged situation many off-label drugs have been tried and there is not found any specific medication, yet. One off-label drug which could be use in a clinical trial is ethanol. The major basis behind the proposal of ethanol therapy in COVID-19 is related to it’s immunomodulatory effects on cytokine storm in this disease [3]. It reduces the inflammatory response and decreases LTR 2, 4, 8, 9 and IL 6 to modify the innate immune system [4,5]. The second part of efficacy of this medication is inhibitory property of ethanol on RNA polymerase respond to virus replication [6,7]. And the third reason, ethanol could involve directly with the bilayer lipid capsule of the coronavirus [8-10]. Other therapeutic effects of ethanol: bronchodilation, decreased work of breathing, anti-cough effects, sedation, and mucolytic properties. Bimodal ethanol therapy (inhalation and intravenous infusion) helps to kill the virus in two directions: a) blood-to-alveolar direction; b) upper-to-lower airway direction. A lot of researches on ethanol therapy were previously conducted in the field of methanol intoxication [11], fat embolism [12], preterm labour [13], pre-eclampsia [14], AF ablation [15], pulmonary edema [16] and many more [17,18].

References

  1. Lai MM and Cavanagh D. “The molecular biology of coronaviruses”. Advances in Virus Research (1997): 1-100.
  2. Wang W., et al. “Detection of SARS-CoV-2 in Different Types of Clinical Specimens”. The Journal of the American Medical Association (2020).
  3. Neupane SP., et al. “Cytokine changes following acute ethanol intoxication in healthy men: a crossover study”. Mediators of Inflammation (2016).
  4. Kany S., et al. “Innate Immunity and Alcohol”. Journal of Clinical Medicine11 (2019): 1981.
  5. Chandrasekar A., et al. “Acute ethanol administration results in a protective cytokine and neuroinflammatory profile in traumatic brain injury”. International Immunopharmacology 51 (2017): 66-75.
  6. Mörs K., et al. “Ethanol decreases inflammatory response in human lung epithelial cells by inhibiting the canonical NF-kB-pathway”. Cellular Physiology and Biochemistry1 (2017): 17-30.
  7. Mark E Berres., et al. “Transcriptome Profiling Identifies Ribosome Biogenesis as a Target of Alcohol Teratogenicity and Vulnerability during Early Embryogenesis”. PLoS ONE1 (2017): e0169351.
  8. Wu H., et al. “Inhibitory effect and possible mechanism of action of patchouli alcohol against influenza A (H2N2) virus”. Molecules 8 (2011): 6489-6501.
  9. Moorer W. “Antiviral activity of alcohol for surface disinfection”. International Journal of Dental Hygiene3 (2003): 138-142.
  10. Kampf G. “Efficacy of ethanol against viruses in hand disinfection”. Journal of Hospital Infection4 (2018): 331-338.
  11. Ekins BR., et al. “Standardized treatment of severe methanol poisoning with ethanol and hemodialysis”. Western Journal of Medicine3 (1985): 337.
  12. Myers R and Taljaard J. “Blood alcohol and fat embolism syndrome”. The Journal of Bone and Joint Surgery American7 (1977): 878-880.
  13. Haas DM., et al. “Ethanol for preventing preterm birth in threatened preterm labor”. Cochrane Database of Systematic Reviews 11 (2015).
  14. Teran E., et al. “Preeclampsia is associated with a decrease in plasma coenzyme Q10 levels”. Free Radical Biology and Medicine11 (2003): 1453-1456.
  15. Schurmann P., et al. “Ethanol for the treatment of cardiac arrhythmias”. Current Opinion in Cardiology4 (2015): 333.
  16. Gootnick A., et al. “Inhalation of ethyl alcohol for pulmonary edema”. New England Journal of Medicine22 (1951): 842-843.
  17. Yang B., et al. “Intra-arterial ethanol embolization augments response to TACE for treatment of HCC with portal venous tumor thrombus”. BMC Cancer1 (2018): 101.
  18. Zhang P., et al. “Inhalation of alcohol vapor driven by oxygen is a useful therapeutic method for postoperative alcohol withdrawal syndrome in a patient with esophageal cancer: a case report”. Alcohol and Alcoholism4 (2011): 424-426.
  19. Cao Y. “Suggestion Using Alcohol Vaporization or Nebulization Inhalation Therapy for Pneumonitis Caused by Coronavirus”. SSRN (2020): 3545744.
  20. CFR - Code of Federal Regulations Title 21.
Citation: Ali Amoushahi and Annemarie Padmos. “A Suggestion on Ethanol Therapy in COVID-19?”. EC Anaesthesia 6.6 (2020): 01-02.

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