The conundrum of using hyperoxia in COVID-19 treatment strategies : may intermittent therapeutic hyperoxia play a helpful role in the expression of the surface receptors ACE2 and Furin in lung tissue via triggering of HIF-1α?

In the current pandemic of severe acute respiratory syndrome corona virus 2 (SARS-CoV-2), the therapeutic administration of oxygen is a common procedure in order to mitigate patient’s hypoxia in the course of severe corona virus disease 2019 (COVID-19) pneumonia. However, additional oxygen causes a variety of well-known side-effects, impacting a number of systems regulating cardiovascular and respiratory homeostasis as well as reactive oxygen species (ROS)-production via oxidative stress.

In this article, we want to focus on intermittent changes in lung and tissue oxygenation, as changes in local pO2 may be able to trigger one of the key effectors of cellular oxygen-sensing, hypoxia-inducible factor-1α (HIF-1α) and, in downstream, the expression of angiotensin-converting enzyme-2 (ACE2) and Furin.

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