Controversy regarding ACE inhibitors / ARBs in COVID-19

Arcos, Federico Soria; Puche, Antonio Romero; Vera, Tomás Vicente

doi:10.1016/j.rec.2020.04.004

Cited by 11 publications

(5 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Third, our patients were from a single geographical area, treated within a single health system; so factors correlated with poor outcomes might differ elsewhere. The lack of medical history at baseline was an additional limitation, recent reports highlighted that some medications, such as angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs), may facilitate severe infection [ 56 ]. Besides, a high frequency of obesity among patients admitted with sever COVID-19 [ 57 ]; however, there were no available data concerning obesity in the present study.…”

Section: Discussionmentioning

confidence: 99%

Predictors of severity and development of critical illness of Egyptian COVID-19 patients: A multicenter study

et al. 2021

View full text Add to dashboard Cite

Objectives We conducted the present multicenter, retrospective study to assess the epidemiological, clinical, laboratory, and radiological characteristics associated with critical illness among patients with COVID-19 from Egypt. Methods The present study was a multicenter, retrospective study that retrieved the data of all Egyptian cases with confirmed COVID-19 admitted to hospitals affiliated to the General Organization for Teaching Hospitals and Institutes (GOTHI) through the period from March to July 2020. The diagnosis of COVID-19 was based on a positive reverse transcription-polymerase chain reaction (RT-PCR) laboratory test. Results This retrospective study included 2724 COVID-19 patients, of whom 423 (15.52%) were critically ill. Approximately 45.86% of the critical group aged above 60 years, compared to 39.59% in the non-critical group (p = 0.016). Multivariate analysis showed that many factors were predictors of critically illness, including age >60 years (OR = 1.30, 95% CI [1.05, 1.61], p = 0.014), low oxygen saturation (OR = 0.93, 95% CI [0.91, 0.95], p<0.001), low Glasgow coma scale (OR = 0.75, 95% CI [0.67, 0.84], p<0.001), diabetes (OR = 1.62, 95% CI [1.26, 2.08], p<0.001), cancer (OR = 2.47, 95% CI [1.41, 4.35], p = 0.002), and serum ferritin (OR = 1.004, 95% CI [1.0003, 1.008], p = 0.031). Conclusion In the present report, we demonstrated that many factors are associated with COVID-19 critical illness, including older age groups, fatigue, elevated temperature, increased pulse, lower oxygen saturation, the preexistence of diabetes, malignancies, cardiovascular disease, renal diseases, and pulmonary disease. Moreover, elevated serum levels of ALT, AST, and ferritin are associated with worse outcomes. Further studies are required to identify independent predictors of mortality for patients with COVID-19.

show abstract

Section: Discussionmentioning

confidence: 99%

Predictors of severity and development of critical illness of Egyptian COVID-19 patients: A multicenter study

et al. 2021

View full text Add to dashboard Cite

show abstract

“…However, transaminases are more commonly elevated than alkaline phosphatase despite that ACE2 is predominantly expressed on cholangiocytes than hepatocytes [ 15 , 16 ]. There has been some concern that about the role of ACE inhibitors in the virulence of SARS-CoV-2 by upregulating the ACE2 receptors [ 17 ]. In the present case, however, the patient was not on any ACE inhibitors.…”

Section: Discussionmentioning

confidence: 99%

Fulminant hepatic failure in a patient testing re-positive for SARS-CoV-2: a case report

et al. 2021

View full text Add to dashboard Cite

Background Infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may not elicit lifelong protective immunity and reinfection could occur. Liver function impairment is a common manifestation of coronavirus disease 2019 (COVID-19). However, acute hepatic failure in the setting of COVID-19 is very rare. Case presentation We report the case of a 47-year-old woman who presented with acute abdominal pain and vomiting. Abdominal examination revealed a soft and lax abdomen with mild tenderness in the right upper quadrant. The patient recovered from COVID-19 2 months previously with negative results on reverse transcription-polymerase chain reaction (RT-PCR). Laboratory investigations revealed markedly elevated transaminases with normal results on viral hepatitis serology panel and undetectable blood paracetamol level. Prior to admission, the patient underwent RT-PCR for SARS-CoV-2, which revealed a positive result. The patient experienced rapid deterioration in the neurological status with a remarkable increase in the liver enzyme levels. Despite aggressive resuscitation, the patient suffered irreversible cardiac arrest and died. Conclusion Fulminant hepatic failure is a rare manifestation in patients with re-positive RT-PCR tests for SARS-CoV-2. Clinicians should maintain a high index of suspicion for hepatic injury with active monitoring of liver enzymes.

show abstract

“…There has been some controversy over the use of these types of medications to treat COVID-19. [32] On the one hand, some studies in animal models have shown that ACEis and ARBs upregulate the production of ACE2. [33] , [34] In addition, the upregulation of ACE2 has been shown to be protective against acute respiratory distress syndrome and acute lung injury.…”

Section: Angiotensin II Receptor Blockers (Arbs) and Angiotensin Covering Enzyme Inhibitors (Acei)mentioning

confidence: 99%

Integrating heterogeneous data to facilitate COVID-19 drug repurposing

Santamaría

Uzquiano

Carro

et al. 2022

Drug Discovery Today

View full text Add to dashboard Cite

In the COVID-19 pandemic, drug repositioning has presented itself as an alternative to the time-consuming process of generating new drugs. This review describes a drug repurposing process that is based on a new data-driven approach: we put forward five information paths that associate COVID-19-related genes and COVID-19 symptoms with drugs that directly target these gene products, that target the symptoms or that treat diseases that are symptomatically or genetically similar to COVID-19. The intersection of the five information paths results in a list of 13 drugs that we suggest as potential candidates against COVID-19. In addition, we have found information in published studies and in clinical trials that support the therapeutic potential of the drugs in our final list.

show abstract

Controversy regarding ACE inhibitors / ARBs in COVID-19

Cited by 11 publications

References 4 publications

Predictors of severity and development of critical illness of Egyptian COVID-19 patients: A multicenter study

Predictors of severity and development of critical illness of Egyptian COVID-19 patients: A multicenter study

Fulminant hepatic failure in a patient testing re-positive for SARS-CoV-2: a case report

Integrating heterogeneous data to facilitate COVID-19 drug repurposing

Contact Info

Product

Resources

About