Unexpected BP Sensitivity to Angiotensin II in a Patient With Coronavirus Disease 2019, ARDS, and Septic Shock.

Wang, Hanyin; Das, Subhraleena; Wieruszewski, Patrick M; Taji, Jamil; Bartlett, Brian; Azad, Nabila; Chowdhury, Arnab; Kolar, Gururaj J; Jain, Nitesh; Subla, Mir R; Khan, Syed Anjum

Wang, Hanyin; Das, Subhraleena; Wieruszewski, Patrick M; Taji, Jamil; Bartlett, Brian; Azad, Nabila; Chowdhury, Arnab; Kolar, Gururaj J; Jain, Nitesh; Subla, Mir R; Khan, Syed Anjum.

Wang H; Department of Hospital Internal Medicine, Mayo Clinic Health System, Mankato, MN.
Das S; Department of Intensive Care, Mayo Clinic Health System, Mankato, MN.
Wieruszewski PM; Department of Pharmacy, Mayo Clinic, Rochester, MN; Multidisciplinary Epidemiology and Translational Research in Intensive Care (METRIC) Group, Rochester, MN.
Taji J; Department of Intensive Care, Mayo Clinic Health System, Mankato, MN; Division of Pulmonology, Mayo Clinic Health System, Mankato, MN.
Bartlett B; Department of Emergency Medicine, Mayo Clinic Health System, Mankato, MN.
Azad N; Department of Hospital Internal Medicine, Mayo Clinic Health System, Mankato, MN.
Chowdhury A; Department of Hospital Internal Medicine, Mayo Clinic Health System, Mankato, MN.
Kolar GJ; Department of Hospital Internal Medicine, Mayo Clinic Health System, Mankato, MN.
Jain N; Department of Intensive Care, Mayo Clinic Health System, Mankato, MN.
Subla MR; Department of Intensive Care, Mayo Clinic Health System, Mankato, MN; Division of Cardiovascular Medicine, Mayo Clinic Health System, Mankato, MN.
Khan SA; Department of Intensive Care, Mayo Clinic Health System, Mankato, MN. Electronic address: khan.syed@mayo.edu.

Chest ; 158(2): e55-e58, 2020 08.

Article in English | MEDLINE | ID: covidwho-211230

ABSTRACT

ABSTRACT

We report the case of an 88-year-old man with coronavirus disease 2019 (COVID-19) who presented with ARDS and septic shock. The patient had exquisite BP sensitivity to low-dose angiotensin II (Ang-2), allowing for rapid liberation from high-dose vasopressors. We hypothesize that sensitivity to Ang-2 might be related to biological effect of severe acute respiratory syndrome coronavirus 2 infection. The case is suggestive of a potential role for synthetic Ang-2 for patients with COVID-19 and septic shock. Further studies are needed to confirm our observed clinical efficacy.

Subject(s)

Angiotensin II/metabolism; Angiotensin-Converting Enzyme Inhibitors/therapeutic use; Coronavirus Infections/drug therapy; Pneumonia, Viral/drug therapy; Respiratory Distress Syndrome/drug therapy; Shock, Septic/drug therapy; Aged, 80 and over; Angiotensin II/drug effects; Betacoronavirus; COVID-19; Coronavirus Infections/complications; Coronavirus Infections/metabolism; Humans; Male; Pandemics; Pneumonia, Viral/complications; Pneumonia, Viral/metabolism; Respiratory Distress Syndrome/etiology; SARS-CoV-2; Shock, Septic/complications; Shock, Septic/metabolism

Keywords

COVID-19; SARS-CoV-2; angiotensin II; septic shock

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Respiratory Distress Syndrome / Shock, Septic / Angiotensin II / Angiotensin-Converting Enzyme Inhibitors / Coronavirus Infections Type of study: Case report / Prognostic study Topics: Long Covid Limits: Humans / Male Language: English Journal: Chest Year: 2020 Document Type: Article Affiliation country: J.chest.2020.04.015

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