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Published on: Nov 13, 2020
1 minute read
By: Dr Rajan ( Medical Second Opinion Cell)

Using The Cellular Handshake Against The Virus

Using the cellular handshake against the virus

In early November an interesting study was published in The Lancet Respiratory Medicine, describing the treatment of a severe COVID-19 patient with human recombinant soluble angiotensin-converting enzyme-2. By using the treatment, it was possible to see the disappearance of the virus swiftly from the patient's serum, nose, and lungs, as well as a reduction in the patients’ inflammatory markers. How was this achieved? And why is this so intriguing.

When we look at treating viruses, there are several strategies at work. You can prevent its spread by the use of social distancing or masks, you can use medications that prevent its replication (such as Tamiflu). Or you can stop the virus from entering the cells, the first step in viral replication.

SARS-CoV-2 appears to enter human cells through the ACE2 receptor. ACE2 is a protein in the cell membrane found across the human body, especially the lungs, heart, kidney and small intestine. It function is related to the Renin-Angiotensin System, a mechanism by which the kidneys control your blood pressure.

Angiotensin-Converting Enzyme converts angiotensin 1 to angiotensin 2, a hormone that causes blood vessels to constrict. ACE 2 instead converts it to a protein that causes dilation of blood vessels. This likely protects these critical organs and ensure they receive sufficient blood to perform their tasks. ACE2 is being investigated as a possible target for blood pressure medications.

The study used a genetically modified soluble form of ACE2 that mimics the protein found on human cell membranes. By increasing its availability in the blood, the SARS-CoV-2 virus binds to this protein, resulting in its inactivation, rather than entering lung cells and causing lung injury. Lab studies have shown that it can reduce viral growth by as much as 1000 to 5000 times, and phase 1 studies show it to be safe to use in people.

The actual described case was in a 45-year-old woman, hospitalized with COVID, suffering from severe shortness of breath, cough and fatigue. She was first treated with hydroxychloroquine and anticoagulants, but this proved ineffective, and the virus was causing increasing damage to her lungs. Nine days after her symptoms started, she received the ACE2 treatment for a week, with no side effects. This resulted in an increase in ACE2 activity (seen from her blood results), but also a marked decrease in multiple inflammatory markers associated with COVID-19, as well as a sharp decrease in COVID 19 numbers. Indeed, the viral load dropped from 32,000 per mL to just 270 per mL two days after treatment started. She was also able to produce antibodies against the virus, so this did not impair her from getting immunity.

It is certainly a very interesting case, though questions remain on how feasible it would be (as well as how expensive) to manufacture large quantities of this protein receptor for treatment use, as well as how it fairs in clinical trials.

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Pale Skin Symptoms: Causes, Health Conditions, and When to Seek Medical Care

Skin colour provides important clues about internal health. When the skin becomes noticeably lighter than usual, it may indicate an underlying medical condition. Pale skin symptoms, also referred to as pallor, are commonly associated with reduced blood flow, low hemoglobin levels or impaired oxygen delivery to tissues.

In India, pale skin is frequently linked to anemia, nutritional deficiencies and chronic illnesses, making early recognition essential.

What Is Pale Skin?

Pale skin refers to:

lighter-than-normal skin tone
reduced redness
pale appearance of lips, gums or nail beds

It can affect the entire body or specific areas such as the face or hands.

Common Pale Skin Symptoms

Typical signs include:

pale face or complexion
pale lips or tongue
light-colored gums
pale nail beds
cold hands and feet
fatigue and weakness

These symptoms often occur together.

Most Common Causes of Pale Skin

Anemia

Anemia occurs when hemoglobin levels are low.

This reduces oxygen delivery to tissues, causing:

pale skin
fatigue
breathlessness
dizziness

NFHS-5 reports anemia affects a large proportion of Indian adults, especially women.

Iron Deficiency

Iron deficiency is the leading cause of anemia.

Contributing factors include:

poor dietary intake
blood loss
absorption problems

ICMR identifies iron deficiency as a major public health issue.

Poor Blood Circulation

Reduced circulation causes:

less blood reaching the skin
visible pallor

Conditions such as heart disease or shock impair circulation.

Acute Blood Loss

Sudden blood loss from:

injury
gastrointestinal bleeding
heavy menstrual bleeding

can cause rapid pallor and weakness.

Chronic Diseases

Chronic illnesses such as:

kidney disease
liver disease
cancer

often cause anemia and pallor over time.

Infections and Inflammation

Severe infections cause:

blood vessel constriction
redistribution of blood flow

This leads to pale or clammy skin.

Nutritional Deficiencies

Deficiencies of:

vitamin B12
folate

affect red blood cell production and cause pallor.

Hormonal Imbalance

Conditions like hypothyroidism reduce metabolic activity, causing:

pale, dry skin
fatigue

Thyroid disorders are common but underdiagnosed.

Genetic Conditions

Inherited disorders such as thalassemia affect hemoglobin production, leading to chronic pallor.

Pale Skin in Children and Older Adults

Children:

may develop pallor due to iron deficiency or infections

Older adults:

often develop pallor due to chronic disease or nutritional deficiency

Both groups need careful evaluation.

Warning Signs That Need Immediate Medical Attention

Seek urgent care if pale skin is associated with:

sudden weakness
chest pain
breathlessness
fainting
rapid heartbeat

These may indicate serious medical emergencies.

How Pale Skin Affects Daily Life

Persistent pallor often causes:

low energy
reduced physical endurance
difficulty concentrating

Quality of life may decline without treatment.

Diagnostic Evaluation

Doctors may recommend:

complete blood count
iron studies
vitamin B12 and folate levels
kidney and liver function tests

Identifying the cause is critical for treatment.

Role of Preventive Health Checkups

Preventive screening helps detect:

early anemia
nutritional deficiencies
chronic disease

Early treatment prevents complications.

Management and Treatment Options

Treatment depends on cause and may include:

iron or vitamin supplementation
treatment of underlying disease
dietary correction
medical therapy for chronic conditions

Self-treatment without diagnosis should be avoided.

Lifestyle Measures to Prevent Pallor

Helpful strategies include:

balanced diet rich in iron and vitamins
adequate hydration
regular health monitoring
treating infections early

Lifestyle changes support long-term health.

Importance of Early Detection

Ignoring pale skin delays diagnosis of:

anemia
internal bleeding
chronic illness

Early recognition improves outcomes.

Conclusion

Pale skin symptoms are more than a cosmetic concern. They often signal anemia, poor circulation, nutritional deficiencies or underlying medical conditions. While temporary pallor may occur due to minor causes, persistent or sudden pale skin requires medical evaluation. Early diagnosis, preventive health screening and appropriate treatment can restore normal skin tone, improve energy levels and protect long-term health.

References

Indian Council of Medical Research (ICMR) – Anemia and Nutritional Deficiency Reports
National Family Health Survey (NFHS-5) – Anemia and Adult Health Data
World Health Organization (WHO) – Anemia and Circulatory Health
Lancet – Pallor, Anemia and Chronic Disease Research
NITI Aayog – Preventive Healthcare and Early Symptom Detection

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