This is not medical advice, or represented to be as such.
COVID-19, has from day one been a puzzling virus, as the effects seen have been far more along the route of an acute Autoimmune disease in some people than a respiratory Virus. The fact that the COVID-19 Virus uses different pathways to gain entry into a cell is another point of emphasis. One of the mechanisms it uses relies on enzyme known as DPP-4. For those who have type II diabetes, this may sound familiar as the well known drug, Junuvia, made headlines when it first came out in 2006, as it heralded in a new class of diabetic medicines which could be used to treat Type II diabetes, known as Gliptins. In studies and in the 14 years since this time, we have learnt a great deal more on exactly how this class of Diabetic medicines work. By nearly eliminating the DPP-4 enzyme which is released after eating a meal, another Enzyme GLP-1 is not broken down as quickly, and it in turn signals the Beta Cells in the Pancreas to continue making insulin and restricted glucagon from being produced. This lowers blood sugar and prevents a marked spike for many people. Now what does all this have to do with COVID-19? Well, a lot in actuality. COVID-19, can in many cases attack internal organs, and much of the reason it does so is because of the channels it uses to replicate.
It has been observed, that Diabetic patients who have had COVID-19 saw their glucose control deteriorate. Many needed to take insulin for this first time. And, this was because of the destruction of Beta Cells by COVID-19, from either creating inflamation or direct destruction of cells. The damage has been short lived in many victims and over 90 days, many regained lost insulin producing capacity. It is a clear illustration of COVID-19 harming an internal organ. Another point to mention, is that DPP-4 activity is higher in older people than in younger populations.
COVID-19 also uses relies on the ACE2 pathway, and here blood pressure drugs come into play. The two most common comorbidity factors besides age, have been Diabetes and High Blood Pressure. These medicines known as ACE inhibitors, actually increase the expression of ACE2, this is known to be a pathway for the COVID-19 virus to use a pathway. This may be a contributing factor to the higher rate of lung damage seen in COVID-19 cases than with other illnesses. High Blood Pressure often accompanies obesity which causes inflammation as an independent factor. This triggers another unresolved autoimmune issue involving DPP-4 as a partial catalyst. It is known that DPP-4 can facilitate an auto immune response, whereby inflammation is continuing to remain unresolved.
So far, these observations have drawn the interest of many experts in the war against COVID-19. The current class of DPP-4 medications, however are not uniform, and it appears they do not directly target the pathway to inhibit COVID-19 at a clinical level. Researchers do hope the will be able to create targeted medicines. A vaccine already exists which works against the production of DPP-4 production in humans. It has not been used widely, but remains a new potential approach in the treatment of Type II Diabetes. It may well be that there may be other ways to treat COVID-19 other than targeting the Virus directly, as shutting down pathways for it’s replication will accomplish at the very least, a viable treatment for those affected. This however, is still at theoretical stage and only time will tell if this possibility becomes reality.