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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
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 Main subject: Pneumonia, Viral / Angiotensin-Converting Enzyme Inhibitors / Coronavirus Infections / Angiotensin Receptor Antagonists / Pandemics / Hypertension Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Traditional medicine Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Journal: Hypertension Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Angiotensin-Converting Enzyme Inhibitors / Coronavirus Infections / Angiotensin Receptor Antagonists / Pandemics / Hypertension Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Traditional medicine Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Journal: Hypertension Year: 2020 Document Type: Article