ABSTRACT
Background: Hypertension is a critical risk factor in increasing the mortality rate of COVID-19 inpatients. This association can be confounded by a history of consuming some angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin-receptor blockers (ARBs). Objective: This study aimed to assess the COVID-19 prognosis in patients with/without a history of taking ACEIs and ARBs. Methods: This single-center, prospective, observational study was performed on 345 patients with COVID-19 hospitalized in Baqiyatallah Hospital. The patients were categorized into 2 groups: with a history of ACEI/ARB consumption (the case group, n=115) and without such a history (the control group, n=230). Results: After the exclusion of some patients, the COVID-19 prognosis of 294 patients (ncontrol =184, ncase=110, 53% female) at a mean age of 64±9.7 years was evaluated. Unequal variables were adjusted between the case and control groups, and the results showed no significant differences in oxygen saturation, the computed tomography scan score, the erythrocyte sedimentation rate, C-reactive protein, lactate dehydrogenase, D-dimer, the white blood cell count, lymphocytes, hemoglobin, platelets, and mortality between the 2 groups. However, a significant difference in the average length of hospital stay was found between the control (6.55±0.56 d) and case (8.53±0.55 d) groups (P=0.013). Conclusions: The dosage adjustments and changes of ACEIs and ARBs are not recommended due to increased referrals to health centers involved with the COVID-19 risk. The prognosis, safety, and efficacy of ACEI/ARB consumption should be assessed further in larger studies on middle-aged to old patients with COVID-19. (Iranian Heart Journal 2022;23(1): 129-139).
ABSTRACT
Since December 2019, an emerging outbreak of a novel coronavirus (SARS-CoV-2) has begun from Wuhan, China, and spread rapidly throughout the world. This systematic review aimed to discuss the involvement of the body's systems during COVID-19 infection comprehensively. PubMed database was used to identify relative studies to be included in this review. Four authors searched PubMed independently using determined search terms. Then, the results were merged and duplicates were removed. The inclusion and exclusion criteria were specified and at least two review authors assessed the eligibility of the studies. The full texts of included studies were reviewed in detail by the authors and the relevant content was extracted and summarized. The pulmonary tract is the most frequent system involved with a wide range of involvement from no pneumonia to white lung and acute respiratory distress syndrome. Computed tomography is the best imaging modality to diagnose COVID-19 infection. Cardiac and renal system injuries are seen during COVID-19 infection and must be taken seriously. Gastrointestinal manifestations are frequently observed during the infection and are probably associated with more severe disease. The placenta acts as an important physiological and immunological barrier that prevents transplacental vertical transmission. COVID-19 infection is a multiorgan involving infection which needs a team of different expertise to diagnose and manage the disease. Although there are many studies available about COVID-19 infection, most of them are focused on pulmonary involvement and the effects of the virus on many other organs and systems remain unclear that shows the necessity of further investigations about the disease.