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Effects of Angiotensin II Receptor Blockers and ACE (Angiotensin-Converting Enzyme) Inhibitors on Virus Infection, Inflammatory Status, and Clinical Outcomes in Patients With COVID-19 and Hypertension: A Single-Center Retrospective Study.
Yang, Guang; Tan, Zihu; Zhou, Ling; Yang, Min; Peng, Lang; Liu, Jinjin; Cai, Jingling; Yang, Ru; Han, Junyan; Huang, Yafei; He, Shaobin.
  • Yang G; From the Department of Geriatrics, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China (G.Y., Z.T., L.P., J.L., J.C., S.H.).
  • Tan Z; Hubei Provincial Academy of Traditional Chinese Medicine, Wuhan, China (G.Y., Z.T., L.P., J.L., J.C., S.H.).
  • Zhou L; From the Department of Geriatrics, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China (G.Y., Z.T., L.P., J.L., J.C., S.H.).
  • Yang M; Hubei Provincial Academy of Traditional Chinese Medicine, Wuhan, China (G.Y., Z.T., L.P., J.L., J.C., S.H.).
  • Peng L; Zhongnan Hospital of Wuhan University, China (L.Z.).
  • Liu J; Department of Preventive Medicine, School of Basic Medicine, Hubei University of Chinese Medicine, Wuhan, China (M.Y.).
  • Cai J; From the Department of Geriatrics, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China (G.Y., Z.T., L.P., J.L., J.C., S.H.).
  • Yang R; Hubei Provincial Academy of Traditional Chinese Medicine, Wuhan, China (G.Y., Z.T., L.P., J.L., J.C., S.H.).
  • Han J; From the Department of Geriatrics, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China (G.Y., Z.T., L.P., J.L., J.C., S.H.).
  • Huang Y; Hubei Provincial Academy of Traditional Chinese Medicine, Wuhan, China (G.Y., Z.T., L.P., J.L., J.C., S.H.).
  • He S; From the Department of Geriatrics, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China (G.Y., Z.T., L.P., J.L., J.C., S.H.).
Hypertension ; 76(1): 51-58, 2020 07.
Article in English | MEDLINE | ID: covidwho-611682
Semantic information from SemMedBD (by NLM)
1. Hypertensive disease PROCESS_OF Patients
Subject
Hypertensive disease
Predicate
PROCESS_OF
Object
Patients
2. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
3. Virus Diseases PROCESS_OF Patients
Subject
Virus Diseases
Predicate
PROCESS_OF
Object
Patients
4. Angiotensin-Converting Enzyme Inhibitors TREATS 2019 novel coronavirus
Subject
Angiotensin-Converting Enzyme Inhibitors
Predicate
TREATS
Object
2019 novel coronavirus
5. ACE2 gene|ACE2 ASSOCIATED_WITH Inflammation
Subject
ACE2 gene|ACE2
Predicate
ASSOCIATED_WITH
Object
Inflammation
6. ACE2 gene|ACE2 ASSOCIATED_WITH Virus Diseases
Subject
ACE2 gene|ACE2
Predicate
ASSOCIATED_WITH
Object
Virus Diseases
7. Angiotensin-Converting Enzyme Inhibitors AFFECTS COVID-19
Subject
Angiotensin-Converting Enzyme Inhibitors
Predicate
AFFECTS
Object
COVID-19
8. Blood Pressure PROCESS_OF Patients
Subject
Blood Pressure
Predicate
PROCESS_OF
Object
Patients
9. Angiotensin-Converting Enzyme Inhibitors TREATS Hypertensive disease
Subject
Angiotensin-Converting Enzyme Inhibitors
Predicate
TREATS
Object
Hypertensive disease
10. Angiotensin-Converting Enzyme Inhibitors TREATS COVID-19
Subject
Angiotensin-Converting Enzyme Inhibitors
Predicate
TREATS
Object
COVID-19
11. Angiotensin-Converting Enzyme Inhibitors TREATS Patients
Subject
Angiotensin-Converting Enzyme Inhibitors
Predicate
TREATS
Object
Patients
12. Hypertensive disease PROCESS_OF Patients
Subject
Hypertensive disease
Predicate
PROCESS_OF
Object
Patients
13. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
14. Virus Diseases PROCESS_OF Patients
Subject
Virus Diseases
Predicate
PROCESS_OF
Object
Patients
15. Angiotensin-Converting Enzyme Inhibitors TREATS 2019 novel coronavirus
Subject
Angiotensin-Converting Enzyme Inhibitors
Predicate
TREATS
Object
2019 novel coronavirus
16. ACE2 gene|ACE2 ASSOCIATED_WITH Inflammation
Subject
ACE2 gene|ACE2
Predicate
ASSOCIATED_WITH
Object
Inflammation
17. ACE2 gene|ACE2 ASSOCIATED_WITH Virus Diseases
Subject
ACE2 gene|ACE2
Predicate
ASSOCIATED_WITH
Object
Virus Diseases
18. Angiotensin-Converting Enzyme Inhibitors AFFECTS COVID-19
Subject
Angiotensin-Converting Enzyme Inhibitors
Predicate
AFFECTS
Object
COVID-19
19. Blood Pressure PROCESS_OF Patients
Subject
Blood Pressure
Predicate
PROCESS_OF
Object
Patients
20. Angiotensin-Converting Enzyme Inhibitors TREATS Hypertensive disease
Subject
Angiotensin-Converting Enzyme Inhibitors
Predicate
TREATS
Object
Hypertensive disease
21. Angiotensin-Converting Enzyme Inhibitors TREATS COVID-19
Subject
Angiotensin-Converting Enzyme Inhibitors
Predicate
TREATS
Object
COVID-19
22. Angiotensin-Converting Enzyme Inhibitors TREATS Patients
Subject
Angiotensin-Converting Enzyme Inhibitors
Predicate
TREATS
Object
Patients
ABSTRACT
With the capability of inducing elevated expression of ACE2 (angiotensin-converting enzyme 2), the cellular receptor for severe acute respiratory syndrome coronavirus 2, angiotensin II receptor blockers (ARBs) or ACE inhibitors treatment may have a controversial role in both facilitating virus infection and reducing pathogenic inflammation. We aimed to evaluate the effects of ARBs/ACE inhibitors on coronavirus disease 2019 (COVID-19) in a retrospective, single-center study. One hundred twenty-six patients with COVID-19 and preexisting hypertension at Hubei Provincial Hospital of Traditional Chinese Medicine in Wuhan from January 5 to February 22, 2020, were retrospectively allocated to ARBs/ACE inhibitors group (n=43) and non-ARBs/ACE inhibitors group (n=83) according to their antihypertensive medication. One hundred twenty-five age- and sex-matched patients with COVID-19 without hypertension were randomly selected as nonhypertension controls. In addition, the medication history of 1942 patients with hypertension that were admitted to Hubei Provincial Hospital of Traditional Chinese Medicine from November 1 to December 31, 2019, before the COVID-19 outbreak were also reviewed for external comparison. Epidemiological, demographic, clinical, and laboratory data were collected, analyzed, and compared between these groups. The frequency of ARBs/ACE inhibitors usage in patients with hypertension with or without COVID-19 were comparable. Among patients with COVID-19 and hypertension, those received either ARBs/ACE inhibitors or non-ARBs/ACE inhibitors had comparable blood pressure. However, ARBs/ACE inhibitors group had significantly lower concentrations of hs-CRP (high-sensitivity C-reactive protein; P=0.049) and PCT (procalcitonin, P=0.008). Furthermore, a lower proportion of critical patients (9.3% versus 22.9%; P=0.061) and a lower death rate (4.7% versus 13.3%; P=0.216) were observed in ARBs/ACE inhibitors group than non-ARBs/ACE inhibitors group, although these differences failed to reach statistical significance. Our findings thus support the use of ARBs/ACE inhibitors in patients with COVID-19 and preexisting hypertension.
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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Pneumonia, Viral / Angiotensin-Converting Enzyme Inhibitors / Coronavirus Infections / Angiotensin Receptor Antagonists / Pandemics / Hypertension Subject: Pneumonia, Viral / Angiotensin-Converting Enzyme Inhibitors / Coronavirus Infections / Angiotensin Receptor Antagonists / Pandemics / Hypertension Type of study: Controlled clinical trial / Clinical Practice Guide / Observational study / Risk factors Language: English Journal: Hypertension Clinical aspect: Therapy Year: 2020

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Pneumonia, Viral / Angiotensin-Converting Enzyme Inhibitors / Coronavirus Infections / Angiotensin Receptor Antagonists / Pandemics / Hypertension Subject: Pneumonia, Viral / Angiotensin-Converting Enzyme Inhibitors / Coronavirus Infections / Angiotensin Receptor Antagonists / Pandemics / Hypertension Type of study: Controlled clinical trial / Clinical Practice Guide / Observational study / Risk factors Language: English Journal: Hypertension Clinical aspect: Therapy Year: 2020
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