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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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Heat Exhaustion Warning Signs: Symptoms You Should Never Ignore

Heat-related illnesses are common during hot weather, particularly in tropical countries like India where summer temperatures can become extreme. Heat exhaustion is a serious condition that occurs when the body overheats due to prolonged exposure to high temperatures and inadequate hydration.

Recognizing heat exhaustion warning signs early can prevent life-threatening complications such as heatstroke.

What Is Heat Exhaustion?

Heat exhaustion is a heat-related illness caused by:

Excessive heat exposure
Dehydration
Loss of electrolytes through sweating

It often occurs during outdoor work, exercise or travel in hot environments.

If untreated, it may progress to heatstroke — a medical emergency.

Common Heat Exhaustion Warning Signs

1. Heavy Sweating

Excessive sweating is one of the earliest signs.

The body attempts to cool itself through perspiration, leading to fluid loss.

2. Dizziness or Lightheadedness

Low blood pressure due to dehydration may cause:

Feeling faint
Blurred vision
Weakness

3. Fatigue and Weakness

Muscle weakness and exhaustion occur as the body struggles to regulate temperature.

4. Nausea and Vomiting

Digestive discomfort is common in heat-related illnesses.

5. Headache

Dehydration and heat stress can trigger throbbing headaches.

6. Muscle Cramps

Electrolyte imbalance may cause painful muscle cramps, especially in legs.

7. Rapid Heartbeat

Increased heart rate helps circulate blood for cooling but may indicate strain.

8. Cool, Clammy Skin

Despite hot weather, skin may feel cool and moist due to heavy sweating.

Who Is at Higher Risk?

Certain groups are more vulnerable:

Outdoor laborers
Athletes
Elderly individuals
Children
People with chronic illnesses
Individuals on certain medications

Urban heat exposure increases risk during peak summer months in India.

Heat Exhaustion vs Heatstroke

Heat exhaustion is serious but manageable if treated promptly.

Heatstroke symptoms include:

High body temperature (above 40°C)
Confusion or disorientation
Dry, hot skin
Seizures
Loss of consciousness

Heatstroke requires immediate emergency medical attention.

Immediate Steps to Take

If heat exhaustion is suspected:

Move to a cool, shaded area
Loosen tight clothing
Drink water or oral rehydration solution
Apply cool cloths to body
Rest until symptoms improve

Seek medical care if symptoms persist beyond one hour.

Prevention Tips

Stay Hydrated

Drink water regularly, even if not thirsty.

Avoid Peak Sun Hours

Limit outdoor activity between 12 PM and 4 PM.

Wear Light Clothing

Choose loose, breathable fabrics.

Use Sun Protection

Wear hats and sunglasses when outdoors.

Take Frequent Breaks

Rest in shaded or air-conditioned areas.

Maintain Electrolyte Balance

Use oral rehydration solutions if sweating heavily.

Heat Illness in the Indian Context

India frequently experiences heatwaves, especially in northern and central regions. Public awareness about hydration and heat safety is essential to reduce hospitalizations and fatalities.

Community-level education can significantly improve prevention.

When to Seek Medical Help

Immediate medical attention is required if:

Symptoms worsen
Body temperature rises significantly
Confusion develops
Fainting occurs
Vomiting persists

Early treatment prevents severe complications.

Conclusion

Heat exhaustion is a preventable but potentially dangerous condition. Recognizing warning signs such as heavy sweating, dizziness, nausea and muscle cramps allows timely intervention.

With rising summer temperatures, especially in India, proactive hydration and heat safety measures are essential. Preventive care and awareness can protect vulnerable individuals and reduce health risks.

Staying cool and hydrated is the simplest way to safeguard your health during hot weather.

References

Indian Meteorological Department – Heatwave Reports
World Health Organization – Heat-Related Illness Guidelines
Indian Council of Medical Research – Public Health Advisory
National Disaster Management Authority (India) – Heatwave Action Plan
Lancet Planetary Health – Climate and Health Research

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