Conclusion
The importance of the host response in infectious disease has been highlighted very recently including the suggestion that ARBs and statins, both very cheap, off patent and in our pharmacies currently could be evaluated to improve outcomes including survival in COVID-19 patients (5). This approach builds upon the pioneering earlier (4, treating of the host concept, based upon an understanding that a beneficial clinical phenotype has been observed with a treatment and this can be employed for the purpose of treating the host.
The approach brings together three concepts; namely the value of therapeutics in stabilizing patients prior to subsequent interventions, repurposing therapeutics for new indications and potential of treating the host. During this review the following became evident;
We have described a framework for treating the host with repurposed drugs and illustrated its use for RAS inhibitors. We would caution that even though there exists observational data highlighting a potential protective effect of RAS inhibition consistent with a pathophysiological alignment this outcome may still be due to chance Therefore based on our analysis we believe a clinical trial for RAS inhibitors would be justified and note that eight trials of this type have already been registered.
Finally, with the advent of COVID-19 disease discussion has moved to delineating the treatment of the host from treatment and elimination of the infective agent to treating the host as out lined and pioneered by David Fedson.
Competing Interests’ Statement - None