tetano
Editor, Senior Moderator
Ann Transl Med. 2020 Apr;8(7):430. doi: 10.21037/atm.2020.03.229.
The effect of RAS blockers on the clinical characteristics of COVID-19 patients with hypertension.
Huang Z[SUP]1[/SUP], Cao J[SUP]1[/SUP], Yao Y[SUP]2[/SUP], Jin X[SUP]1[/SUP], Luo Z[SUP]3[/SUP], Xue Y[SUP]3[/SUP], Zhu C[SUP]4[/SUP], Song Y[SUP]1[/SUP], Wang Y[SUP]1[/SUP], Zou Y[SUP]1[/SUP], Qian J[SUP]1[/SUP], Yu K[SUP]5[/SUP], Gong H[SUP]1[/SUP], Ge J[SUP]1[/SUP].
Author information
Abstract
Background:
Coronavirus disease 2019 (COVID-19), caused by a novel coronavirus (designated as SARS-CoV-2) has become a pandemic worldwide. Based on the current reports, hypertension may be associated with increased risk of sever condition in hospitalized COVID-19 patients. Angiotensin-converting enzyme 2 (ACE2) was recently identified to functional receptor of SARS-CoV-2. Previous experimental data revealed ACE2 level was increased following treatment with ACE inhibitors (ACEIs) and angiotensin receptor blockers (ARBs). Currently doctors concern whether these commonly used renin-angiotensin system (RAS) blockers-ACEIs/ARBs may increase the severity of COVID-19.
Methods:
We extracted data regarding 50 hospitalized hypertension patients with laboratory confirmed COVID-19 in the Renmin Hospital of Wuhan University from Feb 7 to Mar 03, 2020. These patients were grouped into RAS blockers group (Group A, n=20) and non-RAS blockers group (Group B, n=30) according to the basic blood pressure medications. All patients continued to use pre-admission antihypertensive drugs. Clinical severity (symptoms, laboratory and chest CT findings, etc.), clinical course, and short time outcome were analyzed after hospital admission.
Results:
Ten (50%) and seventeen (56.7%) of the Group A and Group B participants were males (P=0.643), and the average age was 52.65?13.12 and 67.77?12.84 years (P=0.000), respectively. The blood pressure of both groups was under effective control. There was no significant difference in clinical severity, clinical course and in-hospital mortality between Group A and Group B. Serum cardiac troponin I (cTnI) (P=0.03), and N-terminal (NT)-pro hormone BNP (NT-proBNP) (P=0.04) showed significant lower level in Group A than in Group B. But the patients with more than 0.04ng/mL or elevated NT-proBNP level had no statistical significance between the two groups. In patients over 65 years or under 65 years, cTnI or NT-proBNP level showed no difference between the two groups.
Conclusions:
We observed there was no obvious difference in clinical characteristics between RAS blockers and non-RAS blockers groups. These data suggest ACEIs/ARBs may have few effects on increasing the clinical severe conditions of COVID-19.
2020 Annals of Translational Medicine. All rights reserved.
KEYWORDS:
ACE inhibitors/angiotensin receptor blockers (ACEIs/ARBs); Coronavirus disease 2019 (COVID-19); angiotensin-converting enzyme 2 (ACE2); hypertension; renin-angiotensin system blockers (RAS blockers)
PMID:32395474PMCID:PMC7210199DOI:10.21037/atm.2020.03.229
The effect of RAS blockers on the clinical characteristics of COVID-19 patients with hypertension.
Huang Z[SUP]1[/SUP], Cao J[SUP]1[/SUP], Yao Y[SUP]2[/SUP], Jin X[SUP]1[/SUP], Luo Z[SUP]3[/SUP], Xue Y[SUP]3[/SUP], Zhu C[SUP]4[/SUP], Song Y[SUP]1[/SUP], Wang Y[SUP]1[/SUP], Zou Y[SUP]1[/SUP], Qian J[SUP]1[/SUP], Yu K[SUP]5[/SUP], Gong H[SUP]1[/SUP], Ge J[SUP]1[/SUP].
Author information
Abstract
Background:
Coronavirus disease 2019 (COVID-19), caused by a novel coronavirus (designated as SARS-CoV-2) has become a pandemic worldwide. Based on the current reports, hypertension may be associated with increased risk of sever condition in hospitalized COVID-19 patients. Angiotensin-converting enzyme 2 (ACE2) was recently identified to functional receptor of SARS-CoV-2. Previous experimental data revealed ACE2 level was increased following treatment with ACE inhibitors (ACEIs) and angiotensin receptor blockers (ARBs). Currently doctors concern whether these commonly used renin-angiotensin system (RAS) blockers-ACEIs/ARBs may increase the severity of COVID-19.
Methods:
We extracted data regarding 50 hospitalized hypertension patients with laboratory confirmed COVID-19 in the Renmin Hospital of Wuhan University from Feb 7 to Mar 03, 2020. These patients were grouped into RAS blockers group (Group A, n=20) and non-RAS blockers group (Group B, n=30) according to the basic blood pressure medications. All patients continued to use pre-admission antihypertensive drugs. Clinical severity (symptoms, laboratory and chest CT findings, etc.), clinical course, and short time outcome were analyzed after hospital admission.
Results:
Ten (50%) and seventeen (56.7%) of the Group A and Group B participants were males (P=0.643), and the average age was 52.65?13.12 and 67.77?12.84 years (P=0.000), respectively. The blood pressure of both groups was under effective control. There was no significant difference in clinical severity, clinical course and in-hospital mortality between Group A and Group B. Serum cardiac troponin I (cTnI) (P=0.03), and N-terminal (NT)-pro hormone BNP (NT-proBNP) (P=0.04) showed significant lower level in Group A than in Group B. But the patients with more than 0.04ng/mL or elevated NT-proBNP level had no statistical significance between the two groups. In patients over 65 years or under 65 years, cTnI or NT-proBNP level showed no difference between the two groups.
Conclusions:
We observed there was no obvious difference in clinical characteristics between RAS blockers and non-RAS blockers groups. These data suggest ACEIs/ARBs may have few effects on increasing the clinical severe conditions of COVID-19.
2020 Annals of Translational Medicine. All rights reserved.
KEYWORDS:
ACE inhibitors/angiotensin receptor blockers (ACEIs/ARBs); Coronavirus disease 2019 (COVID-19); angiotensin-converting enzyme 2 (ACE2); hypertension; renin-angiotensin system blockers (RAS blockers)
PMID:32395474PMCID:PMC7210199DOI:10.21037/atm.2020.03.229