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Neither ACEIs nor ARBs are associated with respiratory distress or mortality in COVID-19 results of a prospective study on a hospital-based cohort

Considerable concern has emerged for the potential harm in the use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor inhibitors (ARBs) in COVID-19 patients, given that ACEIs and ARBs may increase the expression of ACE2 receptors that represent the way for coronavirus 2 to...

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Autores principales: Anzola, Gian Paolo, Bartolaminelli, Clara, Gregorini, Gina Alessandra, Coazzoli, Chiara, Gatti, Francesca, Mora, Alessandra, Charalampakis, Dimitrios, Palmigiano, Andrea, De Simone, Michele, Comini, Alice, Dellaglio, Erica, Cassetti, Salvatore, Chiesa, Maurizio, Spedini, Francesca, d’Ottavi, Patrizia, Savio, Maria Cristina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7508677/
https://www.ncbi.nlm.nih.gov/pubmed/32965603
http://dx.doi.org/10.1007/s11739-020-02500-2
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author Anzola, Gian Paolo
Bartolaminelli, Clara
Gregorini, Gina Alessandra
Coazzoli, Chiara
Gatti, Francesca
Mora, Alessandra
Charalampakis, Dimitrios
Palmigiano, Andrea
De Simone, Michele
Comini, Alice
Dellaglio, Erica
Cassetti, Salvatore
Chiesa, Maurizio
Spedini, Francesca
d’Ottavi, Patrizia
Savio, Maria Cristina
author_facet Anzola, Gian Paolo
Bartolaminelli, Clara
Gregorini, Gina Alessandra
Coazzoli, Chiara
Gatti, Francesca
Mora, Alessandra
Charalampakis, Dimitrios
Palmigiano, Andrea
De Simone, Michele
Comini, Alice
Dellaglio, Erica
Cassetti, Salvatore
Chiesa, Maurizio
Spedini, Francesca
d’Ottavi, Patrizia
Savio, Maria Cristina
author_sort Anzola, Gian Paolo
collection PubMed
description Considerable concern has emerged for the potential harm in the use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor inhibitors (ARBs) in COVID-19 patients, given that ACEIs and ARBs may increase the expression of ACE2 receptors that represent the way for coronavirus 2 to entry into the cell and cause severe acute respiratory syndrome. Assess the effect of ACEI/ARBs on outcome in COVID-19 patients. Hospital-based prospective study. A total of 431 patients consecutively presenting at the Emergency Department and found to be affected by COVID-19 were assessed. Relevant clinical and laboratory variables were recorded, focusing on the type of current anti hypertensive treatment. Outcome variables were NO, MILD, SEVERE respiratory distress (RD) operationally defined and DEATH. Hypertension was the single most frequent comorbidity (221/431 = 51%). Distribution of antihypertensive treatment was: ACEIs 77/221 (35%), ARBs 63/221 (28%), OTHER than ACEIs or ARBs 64/221 (29%). In 17/221 (8%) antihypertensive medication was unknown. The proportion of patients taking ACEIs, ARBs or OTHERs who developed MILD or SEVERE RD was 43/77 (56%), 33/53 (52%), 39/64 (61%) and 19/77 (25%), 16/63 (25%) and 16/64 (25%), respectively, with no statistical difference between groups. Despite producing a RR for SEVERE RD of 2.59 (95% CI 1.93–3.49), hypertension was no longer significant in a logistic regression analysis that identified age, CRP and creatinine as the sole independent predictors of SEVERE RD and DEATH. ACEIs and ARBs do not promote a more severe outcome of COVID-19. There is no reason why they should be withheld in affected patients.
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spelling pubmed-75086772020-09-23 Neither ACEIs nor ARBs are associated with respiratory distress or mortality in COVID-19 results of a prospective study on a hospital-based cohort Anzola, Gian Paolo Bartolaminelli, Clara Gregorini, Gina Alessandra Coazzoli, Chiara Gatti, Francesca Mora, Alessandra Charalampakis, Dimitrios Palmigiano, Andrea De Simone, Michele Comini, Alice Dellaglio, Erica Cassetti, Salvatore Chiesa, Maurizio Spedini, Francesca d’Ottavi, Patrizia Savio, Maria Cristina Intern Emerg Med Im - Original Considerable concern has emerged for the potential harm in the use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor inhibitors (ARBs) in COVID-19 patients, given that ACEIs and ARBs may increase the expression of ACE2 receptors that represent the way for coronavirus 2 to entry into the cell and cause severe acute respiratory syndrome. Assess the effect of ACEI/ARBs on outcome in COVID-19 patients. Hospital-based prospective study. A total of 431 patients consecutively presenting at the Emergency Department and found to be affected by COVID-19 were assessed. Relevant clinical and laboratory variables were recorded, focusing on the type of current anti hypertensive treatment. Outcome variables were NO, MILD, SEVERE respiratory distress (RD) operationally defined and DEATH. Hypertension was the single most frequent comorbidity (221/431 = 51%). Distribution of antihypertensive treatment was: ACEIs 77/221 (35%), ARBs 63/221 (28%), OTHER than ACEIs or ARBs 64/221 (29%). In 17/221 (8%) antihypertensive medication was unknown. The proportion of patients taking ACEIs, ARBs or OTHERs who developed MILD or SEVERE RD was 43/77 (56%), 33/53 (52%), 39/64 (61%) and 19/77 (25%), 16/63 (25%) and 16/64 (25%), respectively, with no statistical difference between groups. Despite producing a RR for SEVERE RD of 2.59 (95% CI 1.93–3.49), hypertension was no longer significant in a logistic regression analysis that identified age, CRP and creatinine as the sole independent predictors of SEVERE RD and DEATH. ACEIs and ARBs do not promote a more severe outcome of COVID-19. There is no reason why they should be withheld in affected patients. Springer International Publishing 2020-09-23 2020 /pmc/articles/PMC7508677/ /pubmed/32965603 http://dx.doi.org/10.1007/s11739-020-02500-2 Text en © Società Italiana di Medicina Interna (SIMI) 2020 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Im - Original
Anzola, Gian Paolo
Bartolaminelli, Clara
Gregorini, Gina Alessandra
Coazzoli, Chiara
Gatti, Francesca
Mora, Alessandra
Charalampakis, Dimitrios
Palmigiano, Andrea
De Simone, Michele
Comini, Alice
Dellaglio, Erica
Cassetti, Salvatore
Chiesa, Maurizio
Spedini, Francesca
d’Ottavi, Patrizia
Savio, Maria Cristina
Neither ACEIs nor ARBs are associated with respiratory distress or mortality in COVID-19 results of a prospective study on a hospital-based cohort
title Neither ACEIs nor ARBs are associated with respiratory distress or mortality in COVID-19 results of a prospective study on a hospital-based cohort
title_full Neither ACEIs nor ARBs are associated with respiratory distress or mortality in COVID-19 results of a prospective study on a hospital-based cohort
title_fullStr Neither ACEIs nor ARBs are associated with respiratory distress or mortality in COVID-19 results of a prospective study on a hospital-based cohort
title_full_unstemmed Neither ACEIs nor ARBs are associated with respiratory distress or mortality in COVID-19 results of a prospective study on a hospital-based cohort
title_short Neither ACEIs nor ARBs are associated with respiratory distress or mortality in COVID-19 results of a prospective study on a hospital-based cohort
title_sort neither aceis nor arbs are associated with respiratory distress or mortality in covid-19 results of a prospective study on a hospital-based cohort
topic Im - Original
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7508677/
https://www.ncbi.nlm.nih.gov/pubmed/32965603
http://dx.doi.org/10.1007/s11739-020-02500-2
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