Differential effects of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers on COVID-19

Abstract

BackgroundThe effect of angiotensin-converting enzyme inhibitor/angiotensin receptor blockers (ACEI/ARB) on the COVID-19 remains controversial from clinic evidence. MethodsThis is a retrospective, two-center case series of 198 consecutive COVID-19 patients with a history of hypertension. ResultsAmong 198 patients, 58 (29.3%) and 16 (8.1%) were on were on ARB and ACEI, respectively. Patients who were on ARB or ACEI/ARB had a significantly lower rate of severe illness and ARDS when compared with patients treated with ACEI alone or not receiving and RAAS blocker (P＜0.05). The Kaplan-Meier survival curve showed that patients with ARB in their antihypertensive regimen had a trend towards a higher survival rate when compared with individuals without ARB (adjusted hazard ratio, 0.27; 95% CI, 0.07-1.02; P = 0.054). The Cox-regression analysis to compared ACEI vs. ARB groups showed a significantly lower mortality rate in the ARB group (adjusted hazard ratio, 0.03; 95% CI, 0.00-0.58; P = 0.02). ConclusionsUsing of ARB was associated with a reduced rate of severe illness and ARDS, indicating their potential protective impact in COVID-19.

Corticosteroids Utilization in the Management of Critically Ill Coronavirus Disease-2019 Pneumonia

“…The novel coronavirus disease-2019 (COVID-19) pandemic has presented great challenges in health care. [ 1 ] Research has shown that 58% of the patients with COVID-19 received corticosteroids therapy when they were hospitalized. [ 2 ] The usefulness and safety of corticosteroids as an adjuvant therapy for COVID-19 pneumonia remain controversial corticosteroids may diminish the inflammatory response, a major factor for lung damage and acute respiratory distress syndrome (ARDS) in viral respiratory tract infection.…”