Angiotensin II - A Brief Review and Role in Severe SARS-COV-2 Sepsis.
J Cardiothorac Vasc Anesth
; 36(12): 4496-4500, 2022 Dec.
Article
in English
| MEDLINE | ID: covidwho-2253756
ABSTRACT
The renin-angiotensin-aldosterone system (RAAS), whose major vasopressor effector is angiotensin II (ATII), has multiple activities and regulates sodium-water homeostasis and fluid and blood pressure homeostasis. RAAS plays a crucial role in cardiocirculatory shock because it counteracts hypotension and hypovolemia by activating different physiologic responses. Based on the encouraging results of the ATHOS-3 trial, the US Food and Drug Administration and the European Medicines Agency approved the use of ATII for catecholamine-resistant vasodilatory shock. More recently, ATII was used for the compassionate treatment of critically ill patients with COVID-19. Beyond its vasopressor properties, ATII was hypothesized to have antiviral activity because it induces internalization and degradation of angiotensin-converting enzyme 2 receptors used by SARS-Cov-2 to infect cells. Overall, the use of ATII in patients with COVID-19 showed promising results because its administration was associated with the achievement and maintenance of target mean arterial pressure, increased PaO2/FIO2 ratio, and decreased FIO2. The aim of this narrative review is to summarize the available knowledge on the use of ATII in patients with COVID-19.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Sepsis
/
COVID-19
Type of study:
Randomized controlled trials
/
Reviews
Limits:
Humans
Language:
English
Journal:
J Cardiothorac Vasc Anesth
Journal subject:
Anesthesiology
/
Cardiology
Year:
2022
Document Type:
Article
Affiliation country:
J.jvca.2022.07.022
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