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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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How Cold Weather Affects Health: Understanding Winter’s Impact on the Body

Seasonal changes influence human health more than most people realise. Cold weather, in particular, places unique stress on the body and can worsen existing health conditions while increasing susceptibility to new illnesses. Understanding how cold weather affects health is essential for preventing seasonal complications and maintaining wellbeing during winter months.

In India, winter-related health issues vary by region but commonly include respiratory infections, cardiovascular strain and joint discomfort. According to the Indian Council of Medical Research (ICMR) and World Health Organization (WHO), cold exposure is associated with increased morbidity, especially among older adults and people with chronic conditions.

Why Cold Weather Impacts the Body

The human body works constantly to maintain core temperature. In cold environments:

blood vessels constrict to conserve heat
energy expenditure increases
immune responses may weaken
organs work harder to maintain balance

These adaptations, while protective, also create health vulnerabilities.

Increased Risk of Infections

Weakened Immune Response

Cold weather can suppress immune function, making it harder for the body to fight infections.

Factors contributing to winter infections include:

reduced vitamin D due to less sunlight
dry air affecting mucosal defenses
closer indoor contact

Common winter infections include colds, flu and respiratory illnesses.

Respiratory Health Problems

Cold air irritates the respiratory tract.

This can lead to:

worsening asthma symptoms
bronchitis flare-ups
increased cough and breathlessness

WHO reports higher hospital admissions for respiratory illnesses during colder months.

Impact on Heart Health

Cold temperatures affect cardiovascular function.

Blood Vessel Constriction

Cold causes blood vessels to narrow, increasing:

blood pressure
heart workload

This raises the risk of:

heart attacks
strokes

People with existing heart disease are particularly vulnerable.

Joint and Muscle Pain

Cold weather affects musculoskeletal health.

Common complaints include:

joint stiffness
muscle aches
worsening arthritis pain

Lower temperatures reduce joint lubrication and increase sensitivity to pain.

Metabolic and Weight Changes

Winter often leads to:

reduced physical activity
increased calorie intake
metabolic slowdown

These changes contribute to weight gain and worsen metabolic conditions such as diabetes.

Skin and Hydration Issues

Cold air holds less moisture.

This leads to:

dry skin
cracked lips
worsening eczema

Dehydration is also common as thirst perception reduces in cold weather.

Mental Health Effects

Seasonal changes can influence mental wellbeing.

Cold weather is associated with:

low mood
reduced motivation
seasonal affective symptoms

Limited sunlight affects circadian rhythm and serotonin levels.

Cold Weather and Older Adults

Elderly individuals face higher risks due to:

reduced temperature regulation
weaker immunity
existing chronic conditions

Winter-related complications are a significant cause of hospitalisation in older populations.

Why Chronic Diseases Worsen in Winter

Conditions such as:

hypertension
arthritis
asthma
diabetes

often worsen due to reduced activity, stress on organs and infection risk.

Preventive Strategies for Winter Health

Maintain Body Warmth

Layered clothing and warm environments reduce cold stress.

Support Immunity

Adequate nutrition, vitamin intake and sleep strengthen immune defences.

Stay Physically Active

Indoor exercises and regular movement prevent stiffness and metabolic decline.

Manage Chronic Conditions

Regular monitoring and medication adherence are critical during winter.

Hydration and Skin Care

Drinking fluids and using moisturisers prevent dehydration and skin damage.

Role of Preventive Healthcare

Preventive healthcare helps:

identify seasonal risk factors
adjust treatment plans
prevent winter complications

NITI Aayog highlights seasonal preparedness as an important public health strategy.

When to Seek Medical Help

Medical attention is necessary if:

infections persist or worsen
chest pain or breathlessness occurs
joint pain limits mobility
mental health symptoms interfere with daily life

Early care prevents serious outcomes.

Long-Term Impact of Ignoring Winter Health Risks

Ignoring cold weather effects may lead to:

severe infections
cardiovascular events
chronic pain progression
reduced quality of life

Seasonal awareness plays a critical role in long-term health.

Conclusion

Understanding how cold weather affects health allows individuals to take timely preventive measures. Winter increases the risk of infections, heart strain, respiratory problems, joint pain and mental health challenges. With proper warmth, nutrition, activity and preventive healthcare, most cold-related health issues are manageable and preventable. Seasonal care is not optional—it is essential for protecting health and wellbeing throughout the colder months.

References

ICMR – Seasonal Health and Infectious Disease Reports
National Family Health Survey (NFHS-5) – Seasonal Morbidity Data
NITI Aayog – Preventive Healthcare and Seasonal Preparedness Strategy
WHO – Cold Weather and Health Impact Guideline
Lancet – Seasonal Variation in Cardiovascular and Respiratory Diseases
Statista – Winter Health Trends and Illness Data
Indian Journal of Public Health – Climate and Health Studies

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