Medical hypotheses
-
The context of the COVID-19 pandemic has highlighted the structural inequalities and vulnerabilities experienced by black communities in the world, and in Brazil it is no different. The data generated in Brazil demonstrate that Brazilian inequality is alarming. Underreporting, non-prioritization of data that consider the variable race and color, and social groups in social vulnerability, help the unequal instrumentalization of epidemiological surveillance; many deaths from the black population are not being accounted for. ⋯ There is emerging evidence that COVID-19 may disproportionately affect black people, who in addition to the vulnerability resulting from socio-spatial conditions, appear to be more susceptible to contamination with a more serious and lethal outcome. Finally, biological differences, such as impaired functioning of the immune response, can be increased by structural racism. In this sense, we reinforce that possible relationships between social and biological vulnerabilities of black communities and the SARS-CoV-2 infection pandemic need to be considered and investigated.
-
Review
Dendritic cell vaccine immunotherapy; the beginning of the end of cancer and COVID-19. A hypothesis.
Immunotherapy is the newest approach to combat cancer. It can be achieved using several strategies, among which is the dendritic cell (DC) vaccine therapy. Several clinical trials are ongoing using DC vaccine therapy either as a sole agent or in combination with other interventions to tackle different types of cancer. ⋯ We hypothesize that DC vaccine therapy may provide a potential treatment strategy to help combat COVID-19. Cancer patients are at the top of the vulnerable population owing to their immune-compromised status. In this review, we discuss DC vaccine therapy in the light of the body's immunity, cancer, and newly emerging infections such as COVID-19 in hopes of better-customized treatment options for patients with multiple comorbidities.
-
No definitive treatment for COVID-19 exists although promising results have been reported with remdesivir and glucocorticoids. Short of a truly effective preventive or curative vaccine against SARS-CoV-2, it is becoming increasingly clear that multiple pathophysiologic processes seen with COVID-19 as well as SARS-CoV-2 itself should be targeted. Because alpha-1-antitrypsin (AAT) embraces a panoply of biologic activities that may antagonize several pathophysiologic mechanisms induced by SARS-CoV-2, we hypothesize that this naturally occurring molecule is a promising agent to ameliorate COVID-19. ⋯ Furthermore, because both NETs formation and the presence of anti-phospholipid antibodies are increased in both COVID-19 and non-COVID pre-eclampsia, it suggests a similar vascular pathogenesis in both disorders. As a final point, AAT has an excellent safety profile when administered to patients with AAT deficiency and is dosed intravenously once weekly but also comes in an inhaled preparation. Thus, AAT is an appealing drug candidate to treat COVID-19 and should be studied.