Abstract Patients at risk of severe forms of COVID 19 share metabolic
disturbances, diabetes, hypertension, among which dysregulation of
antioxydant defence mechanisms and orientation toward Th17 immunological
response are predisposing factors for severe cellular lesions of Covid
infection. We propose to act on NrF2, so as to protect tissues from
oxydative burst, and cellular lesions characteristic of
hyperinflammation of Covid 19. Bardoxolone acts upon Nrf2 and represses
NfKappa B. It has been evaluated in diabetic nephropathy, but some
patients suffered from overhydration and cardiac failure (Beacon study).
In Covid infection, benefit-risk equation is different from long term
use of this drug in diabetic nephropathy, in a disease potentialy lethal
in a couple of weeks, with a short term risk of overhydration which
could be seen as quite negligeable with a daily monitoring of weight. We
advocate for an evaluation of Bardoxolone in recently infected Covid
patients, with severe-Covid19-risk, in a framework of a strict
evaluation of their cardio-vascular risk.