Clinical Features of Patients Infected with the 2019 Novel Coronavirus (COVID-19) in Shanghai, China

Min Cao; Dandan Zhang; Youhua Wang; Yunfei Lu; Xiangdong Zhu; Ying Li; Honghao Xue; Yunxiao Lin; Min Zhang; Yiguo Sun; Zongguo Yang; Jia Shi; Yi Wang; Chang Zhou; Yidan Dong; Ping Liu; Steven M Dudek; Zhen Xiao; Hongzhou Lu; Longping Peng

We observed that 65.4% of COVID-19 patients had decreased serum calcium levels. Calcium influx regulates both clathrin-mediated and clathrin-independent endocytosis during viral infection, thus constituting a key mechanism for regulation of influenza A virus internalization and infection 16 . Based on this theory, calcium channel blockers, including amlodipine, verapamil, and diltiazem, as well as BAPTA-AM, have been proven effective in inhibiting IAV replication in a dose-dependent manner in a canine kidney cell model 17 . Moreover, diltiazem may have both prophylactic and therapeutic effects in IAV treatment according to both ex vivo and in vivo testing 17 . We therefore propose the hypothesis that Ca 2+ levels and/or Ca 2+ channels may play a role in endocytosis and infection of SARS-Cov-2. Further studies are needed to characterize the functional importance of this potential pathway.