The impact of the COVID-19 pandemic on the quality of life of patients with chronic nontransmissible diseases ABSTRACT The pandemic of the new Coronavirus raised fear and uncertainty, increasing the vulnerability of people with Chronic Non-Transmissible Diseases (NCDs) by placing them in a higher risk group for the severe form of the disease.Studies show that the epidemiological security measures have affected the carriers of NCDs, particularly in those of low income, contributing to increased poverty, reduced regular physical activity practice, and changes in eating habits. The current scenario has put on the agenda the need for public policies aimed at the quality of life of the population, considering that these directly interfere with the individual's health status.
After the identification of angiotensin-converting enzyme II (ACE2) as a functional receptor for SARS-CoV-2, it was hypothesized that the chronic use of ACE2 inhibitors and angiotensin AT1 receptor blockers (ARBs II) might be related to the positive regulation of the enzyme in several tissues, and therefore to an increased susceptibility to the virus. The hypothesis provoked divergent opinions since contrary evidence showed that a low expression of ACE2 is involved in the pathological process of lung injury after viral infection. We aimed to review the literature on the risk or benefit of chronic use of antihypertensive drugs in patients exposed to the SARS-CoV-2 virus. The MEDLINE/PubMed ® database was searched using the following keywords: "Angiotensin-converting enzyme inhibitors"; "Angiotensin II receptor blockers"; "Hypertension"; "SARS-CoV-2"; "COVID-19". The search resulted in 230 publications. After reading the available abstracts and full articles, 14 studies were selected that showed content compatibility with the theme. Although there is a lack of consensus among researchers, the use of these drugs should not be interrupted until further evidence is obtained about the use of antihypertensive drugs in patients exposed to the SARS-CoV-2 virus. KEYWORDS: angiotensin-converting enzyme inhibitors; angiotensin II receptor blockers; hypertension; SARS-CoV-2 RESUMO A partir da identificação da enzima conversora de angiotensina II (ECA2), como um receptor funcional para SARS-CoV-2, aventou-se que o uso crônico de inibidores de ECA2 e de bloqueadores do receptor AT1 da angiotensina (BRAs II), poderia estar relacionado a regulação positiva da enzima em vários tecidos e, portanto, a uma maior suscetibilidade ao vírus. A hipótese, provocou opiniões divergentes, posto que, evidências contrárias mostraram que uma baixa expressão da ECA2 se encontra envolvida no processo patológico de lesão pulmonar após a infecção viral. Objetivamos revisar a literatura acerca do risco ou benefício do uso crônico de fármacos anti-hipertensivos em pacientes expostos ao vírus SARS-CoV-2. Realizou-se uma busca na base de dados indexados do MEDLINE/PubMed ® , utilizando os seguintes descritores na língua inglesa: "Angiotensin-converting enzyme inhibitors"; "Angiotensin II receptor blockers"; "Hypertension"; "SARS-CoV-2"; "COVID-19". A busca resultou em 230 publicações. Após a leitura dos resumos e artigos completos disponíveis, foram selecionados 14 estudos que mostraram compatibilidade de conteúdo com o tema. Embora seja observada a falta de consenso entre pesquisadores, o uso destes fármacos não deve ser interrompido até que maiores evidências sejam obtidas acerca do uso dos fármacos anti-hipertensivos em pacientes expostos ao vírus SARS-CoV-2.PALAVRAS-CHAVE bloqueadores do receptor de angiotensina II; hipertensão; inibidores da enzima conversora de angiotensina; SARS-CoV-2
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