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Coronavirus and Sildenafil: How Viagra Might Actually Help

The coronavirus pandemic spread across the world in 2020, reaching every corner of the globe and affecting millions of people. 

With such a tremendous global reach, scientists have been working overtime to develop a COVID-19 vaccine to immunize the population against the infectious disease, and have also been working to develop treatments that are effective in treating SARS-COV-2, particularly in COVID-19 patients who develop a particularly severe version of the disease. Some of the treatments, such as steroids, are fairly traditional, while others are a little more surprising, including sildenafil, the generic form of Viagra. 

When it comes to coronavirus and sildenafil, here’s how the little blue pill might actually help. 

What is coronavirus?

Coronavirus has certainly been a hot topic in the news since early 2020, but while most people are familiar with the virus’ effect on their lives, not everyone fully understands what it is. 

The term coronavirus actually refers to a large family of viruses that cause a wide range of symptoms and illnesses, including severe acute respiratory syndrome (SARS) but it is now most commonly used to refer to the novel coronavirus, also known as COVID-19. COVID 19 first began appearing in Wuhan, China, in December 2019. 

Since then, COVID-19 has infected nearly 94 million people and caused more than 2 million deaths worldwide, including 23.6 million cases and 393,000 deaths in the United States alone as of January 2021.

What symptoms are commonly associated with coronavirus?

Coronavirus typically causes symptoms to appear in people within a 14-day period of exposure to the virus. One of the most interesting things about the virus is that the symptoms can appear very differently from person to person, even within the same family. Some people with coronavirus do not have any symptoms at all but still test positive for the virus, and others may have no other symptoms besides a new loss of taste or smell, further supporting the need for widespread vaccination. 

The most common symptoms of COVID-19 include:

  • Cough
  • Shortness of breath or difficulty breathing
  • Sore throat
  • Diarrhea
  • New fatigue
  • Congestion or runny nose
  • Fever or chills
  • Muscle or body aches
  • Sore throat
  • Headache
  • Nausea or vomiting

Some people, particularly those with certain pre existing medical conditions and elderly people, are more likely to experience a severe form of COVID-19 that can lead to severe acute respiratory problems, kidney failure, or death. 

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Who is most at risk of experiencing a severe form of coronavirus?

As noted above, some people are considered more at risk of suffering from a severe form of COVID-19 that can be potentially fatal. Adults of any age that have any of the following medical conditions are known to be at an increased risk of experiencing severe illness:

  • Cancer
  • Chronic obstructive pulmonary disease (COPD)
  • Cardiovascular conditions like heart failure, coronary artery disease, or cardiomyopathies
  • Obesity (body mass index higher than 30 kg/m but less than 40 kg/m)
  • Severe obesity (body mass index higher than 40 kg/m)
  • Sickle cell disease
  • Type 2 diabetes mellitus
  • Chronic kidney disease
  • Down syndrome
  • Immunocompromised state from solid organ transplant
  • Pregnancy
  • Smoking

Other medical conditions may put adults of any age at an increased risk of experiencing severe illness from COVID-19, including:

  • Asthma
  • Cystic fibrosis
  • Immunocompromised state due to bone marrow transplant, blood transplant, immune deficiencies, HIV, use of corticosteroids, or other medications causing a weakening of the immune system
  • Liver disease
  • Pulmonary fibrosis
  • Pulmonary hypertension
  • Type 1 diabetes mellitus
  • Cerebrovascular disease
  • Hypertension or high blood pressure
  • Neurologic conditions like dementia
  • Overweight (body mass index greater than 25 kg/m but less than 30 kg/m)
  • Thalassemia

In general, children are considered less likely to develop severe illness from COVID-19 compared to adults, and elderly adults (people over the age of 65) are more likely to develop a severe version of the illness.

Treatments for Coronavirus

Doctors are still working to determine which treatment options for coronavirus are the most effective. Currently, remdesivir, an antiviral drug, is the only drug approved by the U.S. Food and Drug Administration (FDA) for the treatment of adults and children ages 12 and older who are hospitalized with coronavirus. Baricitinib, a drug used for the treatment of rheumatoid arthritis, is another medication that has received emergency use authorization from the FDA. 

Some patients are also treated with monoclonal antibodies. Corticosteroids such as prednisone may also be effective at reducing inflammation in people suffering from COVID-19. In addition to these treatment options, doctors are also researching whether sildenafil is a viable treatment option for COVID-19.

What is sildenafil?

Sildenafil is best known as the generic form of the popular drug Viagra. Sildenafil is sold under two different brand names, Viagra and Revatio, and is used to treat several different health conditions. 

Generic sildenafil first became available in December 2017, when the patent on Viagra ran out and other manufacturers were allowed to produce the drug. Sildenafil is used to treat a variety of conditions depending on its dosage, and it is sold in a variety of dosages depending on the condition to be treated. What many people don’t know is that sildenafil may be helpful in treating coronavirus.

What is sildenafil used to treat?

Most people know that sildenafil is used to treat erectile dysfunction in men; the drug’s ability to treat erectile dysfunction has made it one of the most popular medications in the world. However, erectile dysfunction isn’t the only health condition that sildenafil is used to treat, and in fact, it’s not even the reason the drug was developed. Sildenafil was first created for the treatment of chest pain and angina. 

While performing clinical trials for the medication, scientists found  that the study participants were having more erections and were able to maintain an erection for longer. As a result, the manufacturer began marketing Viagra as a treatment for erectile dysfunction. Today, Viagra is used to treat erectile dysfunction, while the other brand name form of sildenafil, Revatio, is used for the treatment of high blood pressure and pulmonary arterial hypertension. 

Depending on the condition being treated, patients will use sildenafil at different doses. High blood pressure and pulmonary arterial hypertension are primarily with a dose of 20 mg, while erectile dysfunction is treated with doses of 20 mg, 40 mg, 60 mg, 80 mg, or 100 mg, depending on the patient. Sildenafil is also sometimes prescribed for the treatment of Raynaud’s Phenomenon, a condition that causes discoloration in the extremities due to a diminished blood supply in local tissues after exposure to changes in temperature. 

How Viagra Might Actually Help Coronavirus

Viagra and its generic equivalent, sildenafil, are most commonly used for the treatment of erectile dysfunction, but sildenafil is also sold under the brand name Revatio. Revatio is used to treat a condition called pulmonary arterial hypertension because the medication helps to dilate blood vessels and increase blood flow. 

Although sildenafil’s power to improve blood flow is normally used to encourage blood cells to flow into the penis, researchers are currently conducting new studies to determine if the medication might also be beneficial in dilating the tiny blood vessels in the lungs. It is believed that sildenafil could help reduce inflammation associated with acute respiratory distress syndrome (ARDS), which is common in people who are seriously ill with COVID. 

How did scientists get the idea to examine whether sildenafil can help treat coronavirus? It all comes back to the drug’s proven effectiveness in treating pulmonary arterial hypertension. Pulmonary arterial hypertension is known to be a complication associated with acute respiratory distress syndrome. 

Scientists hypothesized that sildenafil’s ability to improve blood flow and lower blood pressure might be helpful in treating ARDS, but they also were interested in examining the potential for high nitric oxide levels, produced by drugs that include sildenafil, to help with fighting the virus.

If you’re confused as to how nitric oxide levels might help with virus prevention, look no further than the SARS (severe acute respiratory syndrome) outbreak that occurred in 2003. In studying the virus, scientists discovered that nitric oxide inhibits the replication cycle of severe acute respiratory syndrome and effectively serves as an antiviral medication. Additionally, inhaled nitric oxide has been found to improve blood flow in the lungs without affecting blood flow elsewhere in the body, making it a viable treatment for pulmonary arterial hypertension. 

Summary

More research needs to be done to determine if sildenafil is a viable treatment option for coronavirus, but early research and clinical trials indicate that there could be a link between the two. It is anticipated that more information about efficacy and side effects will become available in 2021 as clinical trials continue. 

Sources:

https://clinicaltrials.gov/ct2/show/NCT04489446 

https://jvi.asm.org/content/79/3/1966 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7478270/ 

https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus 

https://linkinghub.elsevier.com/retrieve/pii/S1473309920301201 

https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html

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Published January 18th, 2021 by Chris Riley
Fact Checked by
Camille Freking
Medically Reviewed:
Gerardo Sison
Updated Date: Feb 5th, 2021

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