Acute respiratory distress syndrome and subsequent respiratory failure remains the leading cause of death (>80%) in patients severely impacted by COVID-19. The lack of clinically effective therapies for COVID-19 calls for the consideration of novel adjunct therapeutic approaches. Though novel antiviral treatments and vaccination hold promise in control and prevention of early disease, it is noteworthy that in severe cases of COVID-19, addressing "run-away" inflammatory cascades are likely more relevant for improvement of clinical outcomes. Viral loads may decrease in severe, end-stage coronavirus cases, but a systemically damaging cytokine storm persists and mediates multiple organ injury. Remote ischemic conditioning (RIC) of the limbs has shown potential in recent years to protect the lungs and other organs against pathological conditions similar to that observed in COVID-19. We review the efficacy of RIC in protecting the lungs against acute injury and current points of consideration. The beneficial effects of RIC on lung injury along with other related cardiovascular complications are discussed, as are the limitations presented by sex and ageing. This adjunct therapy is highly feasible, non-invasive, and proven to be safe in clinical conditions. If proven effective in clinical trials for acute respiratory distress syndrome and COVID-19, application in the clinical setting could be immediately implemented to improve outcomes.

中文翻译：

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远程缺血条件治疗COVID-19中的急性呼吸窘迫综合征

在受COVID-19严重影响的患者中，急性呼吸窘迫综合征和随后的呼吸衰竭仍然是主要的死亡原因（> 80％）。缺乏针对COVID-19的临床有效疗法，需要考虑采用新型辅助疗法。尽管新型抗病毒治疗和疫苗接种有望控制和预防早期疾病，但值得注意的是，在COVID-19的严重病例中，解决“失控”的炎症反应可能与改善临床结局更相关。在严重的终末冠状病毒病例中，病毒载量可能会降低，但系统性破坏性细胞因子风暴仍会持续并介导多器官损伤。近年来，四肢的远端缺血性调节（RIC）已显示出潜力，可以保护肺和其他器官免受类似于COVID-19所观察到的病理状况的伤害。我们回顾了RIC在保护肺部免受急性损伤的功效和当前的考虑点。讨论了RIC对肺损伤以及其他相关心血管并发症的有益作用，以及性别和年龄限制。这种辅助疗法是高度可行的，非侵入性的，并且在临床条件下被证明是安全的。如果在急性呼吸窘迫综合征和COVID-19的临床试验中证明有效，则可以立即在临床环境中应用以改善结局。我们回顾了RIC在保护肺部免受急性损伤的功效和当前的考虑点。讨论了RIC对肺损伤以及其他相关心血管并发症的有益作用，以及性别和年龄限制。这种辅助疗法是高度可行的，非侵入性的，并且在临床条件下被证明是安全的。如果在急性呼吸窘迫综合征和COVID-19的临床试验中证明有效，则可以立即在临床环境中应用以改善结局。我们回顾了RIC在保护肺部免受急性损伤的功效和当前的考虑点。讨论了RIC对肺损伤以及其他相关心血管并发症的有益作用，以及性别和年龄限制。这种辅助疗法是高度可行的，非侵入性的，并且在临床条件下被证明是安全的。如果在急性呼吸窘迫综合征和COVID-19的临床试验中证明有效，则可以立即在临床环境中应用以改善结局。并在临床条件下被证明是安全的。如果在急性呼吸窘迫综合征和COVID-19的临床试验中证明有效，则可以立即在临床环境中应用以改善结局。并在临床条件下被证明是安全的。如果在急性呼吸窘迫综合征和COVID-19的临床试验中证明有效，则可以立即在临床环境中应用以改善结局。