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1.
J Infect Dis ; 2021 Dec 13.
Article in English | MEDLINE | ID: covidwho-1569706
2.
Pharmacol Res Perspect ; 9(6): e00861, 2021 12.
Article in English | MEDLINE | ID: covidwho-1487514

ABSTRACT

Most but not all observational studies of statin treatment of COVID-19 patients suggest that treatment improves outcomes. However, almost all of these studies fail to consider that withdrawing statins after hospital admission may have detrimental effects, a finding which cardiovascular investigators have known for 15-20 years. Continuing or starting statin treatment after hospital admission consistently improves cardiovascular outcomes. Similarly, inpatient statin treatment of COVID-19 improves survival. For this reason, observational studies of the effectiveness of outpatient-documented statin treatment of COVID-19 patients must consider the negative consequences of statin withdrawal after hospital admission.


Subject(s)
COVID-19/drug therapy , Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage , Hospital Mortality , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Meta-Analysis as Topic , Observational Studies as Topic , Patient Admission , Treatment Outcome , Withholding Treatment
3.
Hum Vaccin Immunother ; 17(9): 2841-2850, 2021 09 02.
Article in English | MEDLINE | ID: covidwho-1246659

ABSTRACT

The COVID-19 pandemic has disrupted life throughout the world. Newly developed vaccines promise relief to people who live in high-income countries, although vaccines and expensive new treatments are unlikely to arrive in time to help people who live in low-and middle-income countries. The pathogenesis of COVID-19 is characterized by endothelial dysfunction. Several widely available drugs like statins, ACE inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) have immunometabolic activities that (among other things) maintain or restore endothelial cell function. For this reason, we undertook an observational study in four Belgian hospitals to determine whether in-hospital treatment with these drugs could improve survival in 959 COVID-19 patients. We found that treatment with statins and ACEIs/ARBs reduced 28-day mortality in hospitalized COVID-19 patients. Moreover, combination treatment with these drugs resulted in a 3-fold reduction in the odds of hospital mortality (OR = 0.33; 95% CI 0.17-0.69). These findings were in general agreement with other published studies. Additional observational studies and clinical trials are needed to convincingly show that in-hospital treatment with statins, ACEIs/ARBs, and especially their combination saves lives.


Subject(s)
COVID-19 , Hydroxymethylglutaryl-CoA Reductase Inhibitors , Hypertension , Angiotensin Receptor Antagonists/therapeutic use , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Belgium/epidemiology , Hospital Mortality , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Pandemics , SARS-CoV-2
4.
J Public Health Policy ; 42(1): 6-14, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-955848

ABSTRACT

Health officials and scientists have warned that we face the threat of a potentially devastating influenza pandemic. Instead, we are now in the midst of a global coronavirus (COVID-19) pandemic. National and international pandemic preparedness plans have focused on developing vaccines and antiviral treatments. Another way to confront the COVID-19 pandemic (and future pandemics) might be to treat patients with inexpensive and widely available generic drugs that target the host response to infection, not the virus itself. The feasibility of this idea was tested during the Ebola outbreak in West Africa in 2014. This experience should inform our approach to treating COVID-19 patients. It could also save lives during outbreaks of other emerging infectious diseases and episodes of everyday acute critical illness. If this "bottom up" syndromic approach to treating acute critical illness were shown to be effective, it could have a dramatic impact on health, equity and security throughout the world. HIGHLIGHTS: Uncertainty about the outcome of COVID-19 is driving the social, economic and political distress associated with the pandemic. Treating the host response to COVID-19 with inexpensive and widely available generic drugs might save lives and mitigate this distress. Undertaking research on this idea will require political leadership.


Subject(s)
Antiviral Agents/therapeutic use , COVID-19/drug therapy , Drugs, Generic/therapeutic use , Leadership , Pneumonia, Viral/drug therapy , Politics , Antiviral Agents/supply & distribution , Biomedical Research , COVID-19/epidemiology , COVID-19 Vaccines , Drugs, Generic/supply & distribution , Humans , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , SARS-CoV-2
5.
Am J Cardiol ; 136: 171-173, 2020 12 01.
Article in English | MEDLINE | ID: covidwho-799227
7.
mBio ; 11(2)2020 03 20.
Article in English | MEDLINE | ID: covidwho-11461

ABSTRACT

Patients with COVID-19 infection are at risk of acute respiratory disease syndrome (ARDS) and death. The tissue receptor for COVID-19 is ACE2, and higher levels of ACE2 can protect against ARDS. Angiotensin receptor blockers and statins upregulate ACE2. Clinical trials are needed to determine whether this drug combination might be used to treat patients with severe COVID-19 infection.


Subject(s)
Betacoronavirus , Coronavirus Infections/metabolism , Coronavirus Infections/therapy , Pneumonia, Viral/metabolism , Pneumonia, Viral/therapy , Receptor, Angiotensin, Type 2/biosynthesis , Receptors, Virus/biosynthesis , Angiotensin II Type 2 Receptor Blockers/therapeutic use , Angiotensin-Converting Enzyme 2 , COVID-19 , Coronavirus Infections/drug therapy , Coronavirus Infections/virology , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Peptidyl-Dipeptidase A/metabolism , Pneumonia, Viral/virology , Receptors, Coronavirus , SARS-CoV-2
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