Coronavirus Disease 2019 (COVID-19) is upsetting the world and innovative therapeutic solutions are needed in an attempt to counter this new pandemic. Great hope lies in vaccines, but drugs to cure the infected patient are just as necessary. In the most severe forms of the disease, a cytokine storm with neuroinflammation occurs, putting the patient’s life at serious risk, with sometimes long-lasting sequelae. Palmitoylethanolamide (PEA) is known to possess anti-inflammatory and neuroprotective properties, which make it an ideal candidate to be assumed in the earliest stage of the disease. Here, we provide a mini-review on the topic, pointing out phospholipids consumption in COVID-19, the possible development of an antiphospholipid syndrome secondary to SARS-CoV-2 infection, and reporting our preliminary single-case experience concerning to a 45-year-old COVID-19 female patient recently treated with success by micronized / ultramicronized PEA.
Like other coronaviruses, the outer surface of SARS-CoV-2 consists of an envelope (colored in gray) and of 3 structural proteins, namely envelope (E, yellow), membrane (M,orange) and spike (S, red) proteins. The envelope is made up of a phospholipid bilayer,which derives via budding from membrane portions of the host cell infected by the virus.
Each phospholipid contains 1 hydrophilic phosphate group and 2 hydrophobic tails of fatty acids, precursors of PEA, as shown by PEA skeletal formula [the 3D illustration of SARS-CoV-2 has been created by Alissa Eckert, MS, and Dan Higgins, MAM, at the Centers for Disease Control and Prevention (CDC) of Atlanta, Georgia, USA, placed in the public domain and thus free of any copyright restrictions].
Fig. 2. Frontal (A) and lateral (B) projections of the patient’s chest X-ray at the early onset of SARS-CoV-2 infection: no signs of interstitial pneumonia in progress are noticeable. The patient was sent back to her home in quarantine, where she immediately started PEA assumption under constant medical supervision.
According to the British National Institute for Health and Care Excellence (NICE), COVID-19 can be subdivided into 3 clinical definitions: acute COVID-19 for symptoms and signs within the first 4 weeks following SARS-CoV-2 infection; ongoing symptomatic COVID-19 (sub-acute COVID-19) for effects from 4 to 12 weeks from the disease onset; and post−COVID-19 syndrome (chronic COVID-19) for signs and clusters of symptoms that persist 12 or more weeks after SARS-CoV-2 infection, and not explained by an alternative diagnosis. The patient-created term «long COVID» (long-haul COVID) includes both ongoing symptomatic COVID-19 and post−COVID-19 syndrome.
