Possibilities of using beta-blockers in catecholamine storm in patients with new coronavirus infection (COVID-19)

The review article presents data from scientific studies on the use of beta-blockers (BB) in catecholamine storm (CS) in patients with novel coronavirus infection (COVID-19). BBs may have potential benefits in the treatment of COVID-19, but current data on the potential mechanism of action of BBs is still scarce. However, several mechanisms of BD have been proposed, including a decrease in the activity of the renin-angiotensin-aldosterone system (RAAS), angiotensin-converting enzyme-2 (ACE-2) levels, a decrease in cytokine storms due to a decrease in the level of various pro-inflammatory cytokines, including IL-6, IL-1, IL-1β, tumor necrosis factor-α (TNFα), T-helper 17 (Th17) and interferon-γ. IFNγ), which can be very useful in reducing mortality in COVID-19 associated with the development of acute respiratory distress syndrome (ARDS). Elevated catecholamine levels activate the adrenergic system, which leads to activation of the RAAS, which facilitates the entry of SARS-CoV-2 and leads to complications of COVID-19. The effect of BB may counteract harmful sympathetic activation during cytokine storm in severe disease. The use of BBs when combined with elevated norepinephrine levels with sepsis or septic shock associated with COVID-19 may have promising results. In addition, the review article indicates a good effect of cardioselective BBs in the treatment of drug-induced arrhythmias. The article concludes by pointing out that additional large-scale randomized clinical trials are needed before definitive recommendations can be made on the potential use of BB in COVID-19.