Abstract: Metabolic syndrome, a “cluster” of metabolic disorders including hypertension, increases the cardiovascular risk, and insulin resistance plays a key role in its pathogenesis. In this syndrome antihypertensive treatment with betablockers is underused because of their adverse metabolic effects. The aim was to review the evidences supporting the reasons for under-using beta-blockers in hypertensive patients with metabolic syndrome. A review of Literature has been carried out via PubMed from 1998 to 2008: most of beta-blockers have adverse effects on insulin sensitivity, carbohydrate and lipid metabolism, and are not recommended in metabolic syndrome. However, some recent large studies have shown a better metabolic profile with newer third generation vasodilating beta-blockers, such as Carvedilol and Nebivolol. Vasodilating action of Carvedilol and Nebivolol, due respectively to alpha1-blocking effect and release of nitric oxide, explains the lack of adverse metabolic effects of these beta-blockers that could also be used in hypertensive patients with metabolic syndrome.

Recently, the rapid and extensive spread of a novel human RNA betacoronavirus, known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is causing a worldwide public health emergency, originated in Wuhan, China. The disease caused by this new coronavirus, called "COVID-19", is very contagious. Although most of infected subjects are asymptomatic or present with mild flu-like symptoms, the rapid spread of the virus has resulted in a significant amount of serious interstitial pneumonia that may quickly develop into severe acute respiratory distress syndrome (ARDS), septic shock, sepsis-induced coagulopathy and fatal multiorgan dysfunction. Hence, the unabated spread of the disease demands an immediate need to explore all the plausible therapeutic and prophylactic strategies for reducing the high morbidity and mortality of this infection. At present, there is no vaccine or certainly effective antiviral treatment for human SARS-Cov-2 and the mainstay of clinical management is prevalently symptomatic treatment combined with a panel of drugs having variable and uncertain efficacy. Unfortunately, no many drugs have yet been approved to treat human SARS-Cov-2 infection and many agents are administered in off label route; several options are being studied to control or prevent clinical manifestations of this infection, including monoclonal antibodies, antiviral and anti-cytokine agents, antibiotics, and other drugs. Given that several vitamins are known to have antimicrobial properties and immunomodulatory activity, a potential role of vitamins in the COVID-19 treatment was investigated.