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The effect of RAS blockers on the clinical characteristics of COVID-19 patients with hypertension

BACKGROUND: Coronavirus disease 2019 (COVID-19), caused by a novel coronavirus (designated as SARS-CoV-2) has become a pandemic worldwide. Based on the current reports, hypertension may be associated with increased risk of sever condition in hospitalized COVID-19 patients. Angiotensin-converting enz...

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Autores principales: Huang, Zheyong, Cao, Jiatian, Yao, Yumeng, Jin, Xuejuan, Luo, Zhe, Xue, Yuan, Zhu, Chouwen, Song, Yanan, Wang, Ying, Zou, Yunzeng, Qian, Juying, Yu, Kaihuan, Gong, Hui, Ge, Junbo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7210199/
https://www.ncbi.nlm.nih.gov/pubmed/32395474
http://dx.doi.org/10.21037/atm.2020.03.229
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author Huang, Zheyong
Cao, Jiatian
Yao, Yumeng
Jin, Xuejuan
Luo, Zhe
Xue, Yuan
Zhu, Chouwen
Song, Yanan
Wang, Ying
Zou, Yunzeng
Qian, Juying
Yu, Kaihuan
Gong, Hui
Ge, Junbo
author_facet Huang, Zheyong
Cao, Jiatian
Yao, Yumeng
Jin, Xuejuan
Luo, Zhe
Xue, Yuan
Zhu, Chouwen
Song, Yanan
Wang, Ying
Zou, Yunzeng
Qian, Juying
Yu, Kaihuan
Gong, Hui
Ge, Junbo
author_sort Huang, Zheyong
collection PubMed
description BACKGROUND: Coronavirus disease 2019 (COVID-19), caused by a novel coronavirus (designated as SARS-CoV-2) has become a pandemic worldwide. Based on the current reports, hypertension may be associated with increased risk of sever condition in hospitalized COVID-19 patients. Angiotensin-converting enzyme 2 (ACE2) was recently identified to functional receptor of SARS-CoV-2. Previous experimental data revealed ACE2 level was increased following treatment with ACE inhibitors (ACEIs) and angiotensin receptor blockers (ARBs). Currently doctors concern whether these commonly used renin-angiotensin system (RAS) blockers-ACEIs/ARBs may increase the severity of COVID-19. METHODS: We extracted data regarding 50 hospitalized hypertension patients with laboratory confirmed COVID-19 in the Renmin Hospital of Wuhan University from Feb 7 to Mar 03, 2020. These patients were grouped into RAS blockers group (Group A, n=20) and non-RAS blockers group (Group B, n=30) according to the basic blood pressure medications. All patients continued to use pre-admission antihypertensive drugs. Clinical severity (symptoms, laboratory and chest CT findings, etc.), clinical course, and short time outcome were analyzed after hospital admission. RESULTS: Ten (50%) and seventeen (56.7%) of the Group A and Group B participants were males (P=0.643), and the average age was 52.65±13.12 and 67.77±12.84 years (P=0.000), respectively. The blood pressure of both groups was under effective control. There was no significant difference in clinical severity, clinical course and in-hospital mortality between Group A and Group B. Serum cardiac troponin I (cTnI) (P=0.03), and N-terminal (NT)-pro hormone BNP (NT-proBNP) (P=0.04) showed significant lower level in Group A than in Group B. But the patients with more than 0.04ng/mL or elevated NT-proBNP level had no statistical significance between the two groups. In patients over 65 years or under 65 years, cTnI or NT-proBNP level showed no difference between the two groups. CONCLUSIONS: We observed there was no obvious difference in clinical characteristics between RAS blockers and non-RAS blockers groups. These data suggest ACEIs/ARBs may have few effects on increasing the clinical severe conditions of COVID-19.
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spelling pubmed-72101992020-05-11 The effect of RAS blockers on the clinical characteristics of COVID-19 patients with hypertension Huang, Zheyong Cao, Jiatian Yao, Yumeng Jin, Xuejuan Luo, Zhe Xue, Yuan Zhu, Chouwen Song, Yanan Wang, Ying Zou, Yunzeng Qian, Juying Yu, Kaihuan Gong, Hui Ge, Junbo Ann Transl Med Original Article BACKGROUND: Coronavirus disease 2019 (COVID-19), caused by a novel coronavirus (designated as SARS-CoV-2) has become a pandemic worldwide. Based on the current reports, hypertension may be associated with increased risk of sever condition in hospitalized COVID-19 patients. Angiotensin-converting enzyme 2 (ACE2) was recently identified to functional receptor of SARS-CoV-2. Previous experimental data revealed ACE2 level was increased following treatment with ACE inhibitors (ACEIs) and angiotensin receptor blockers (ARBs). Currently doctors concern whether these commonly used renin-angiotensin system (RAS) blockers-ACEIs/ARBs may increase the severity of COVID-19. METHODS: We extracted data regarding 50 hospitalized hypertension patients with laboratory confirmed COVID-19 in the Renmin Hospital of Wuhan University from Feb 7 to Mar 03, 2020. These patients were grouped into RAS blockers group (Group A, n=20) and non-RAS blockers group (Group B, n=30) according to the basic blood pressure medications. All patients continued to use pre-admission antihypertensive drugs. Clinical severity (symptoms, laboratory and chest CT findings, etc.), clinical course, and short time outcome were analyzed after hospital admission. RESULTS: Ten (50%) and seventeen (56.7%) of the Group A and Group B participants were males (P=0.643), and the average age was 52.65±13.12 and 67.77±12.84 years (P=0.000), respectively. The blood pressure of both groups was under effective control. There was no significant difference in clinical severity, clinical course and in-hospital mortality between Group A and Group B. Serum cardiac troponin I (cTnI) (P=0.03), and N-terminal (NT)-pro hormone BNP (NT-proBNP) (P=0.04) showed significant lower level in Group A than in Group B. But the patients with more than 0.04ng/mL or elevated NT-proBNP level had no statistical significance between the two groups. In patients over 65 years or under 65 years, cTnI or NT-proBNP level showed no difference between the two groups. CONCLUSIONS: We observed there was no obvious difference in clinical characteristics between RAS blockers and non-RAS blockers groups. These data suggest ACEIs/ARBs may have few effects on increasing the clinical severe conditions of COVID-19. AME Publishing Company 2020-04 /pmc/articles/PMC7210199/ /pubmed/32395474 http://dx.doi.org/10.21037/atm.2020.03.229 Text en 2020 Annals of Translational Medicine. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Huang, Zheyong
Cao, Jiatian
Yao, Yumeng
Jin, Xuejuan
Luo, Zhe
Xue, Yuan
Zhu, Chouwen
Song, Yanan
Wang, Ying
Zou, Yunzeng
Qian, Juying
Yu, Kaihuan
Gong, Hui
Ge, Junbo
The effect of RAS blockers on the clinical characteristics of COVID-19 patients with hypertension
title The effect of RAS blockers on the clinical characteristics of COVID-19 patients with hypertension
title_full The effect of RAS blockers on the clinical characteristics of COVID-19 patients with hypertension
title_fullStr The effect of RAS blockers on the clinical characteristics of COVID-19 patients with hypertension
title_full_unstemmed The effect of RAS blockers on the clinical characteristics of COVID-19 patients with hypertension
title_short The effect of RAS blockers on the clinical characteristics of COVID-19 patients with hypertension
title_sort effect of ras blockers on the clinical characteristics of covid-19 patients with hypertension
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7210199/
https://www.ncbi.nlm.nih.gov/pubmed/32395474
http://dx.doi.org/10.21037/atm.2020.03.229
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