The potential role of carvedilol in COVID-19 management: perspective and take-away.

Carvedilol (CVL) is a lipophilic third generation non-selective beta and alpha-1 adrenoceptor blocker. CVL has pleiotropic antioxidant and anti-inflammatory effects by reducing the production of reactive oxygen species (ROS) and inhibiting of inflammatory signaling pathways. In virtue of its antioxidant and anti-inflammatory effects, CVL can ameliorate COVID-19 and related complications. Therefore, the aim of the present review was to illustrate the potential role of CVL in the management of COVID-19. CVL has anti-SARS-CoV-2 activity by inhibiting 3-CLpro, which is involved in the replication of this virus. CVL inhibits the release of pro-inflammatory cytokines, improves anti-inflammatory cytokines, inhibit β/αadrenoceptors-mediated immune activation, and suppression of sympathetic over-activity. Thus, CVL may prevent the association between sympathetic and cytokine storms in COVID-19. These verdicts suggest that CVL through its antioxidant, anti-inflammatory, and blocking of β/αadrenoceptors, might be a possible candidate against COVID-19-induced inflammatory changes, oxidative stress, and the development of dysautonomia. In conclusion, CVL could be a possible drug in the management of COVID-19 by attenuating the development of cytokine and sympathetic storms.