Effects of Angiotensin II Receptor Blockers on the Risk of Mortality in Patients with COVID-19: An Updated Systematic Review and Meta-analysis of Randomized Trials

Kow, Chia Siang; Ramachandram, Dinesh Sangarran; Hasan, Syed Shahzad

doi:10.1093/ajh/hpac070

Cited by 2 publications

(3 citation statements)

References 4 publications

(9 reference statements)

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“…These results have raised a great question in the international scientific community as to why two drugs from the same pharmacological group (ARBs) used in equivalent antihypertensive doses, one of them (telmisartan) is effective, and the other (losartan) is not, in patients hospitalized with COVID-19. [8][9][10][11] The objective of this manuscript was to compare the chemical and pharmacological properties of telmisartan and losartan, which, due to their marked differences, support the results obtained with the administration of both agents in patients hospitalized with COVID-19.…”

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confidence: 75%

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Telmisartan and losartan: The marked differences between their chemical and pharmacological properties may explain the difference in therapeutic efficacy in hospitalized patients with COVID‐19

Rothlin¹,

Pelorosso²,

Duarte

et al. 2023

Pharmacology Res & Perspec

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confidence: 75%

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confidence: 99%

Telmisartan and losartan: The marked differences between their chemical and pharmacological properties may explain the difference in therapeutic efficacy in hospitalized patients with COVID‐19

Rothlin¹,

Pelorosso²,

Duarte

et al. 2023

Pharmacology Res & Perspec

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“…In the absence of old age and comorbidities in SARS-CoV-2, miR-155’s purposeful overexpression appears to induce a hyperactive, albeit protective RAAS state, very similar to the one seen with ARBs in CV disease and in BS/GS [ 2 , 61 , 73 , 104 ]. Pharmacological RAAS inhibition (RAASi) effects in SARS-CoV-2 have been actively debated [ 107 ]. MiR-155 levels are reportedly decreased in coronary artery disease (CAD) compared to healthy subjects and concurrent ARB or ACE inhibitor (ACEi) treatment induced further reduction in miR-155 levels versus no ARB/ACEi [ 108 , 109 ].…”

Section: Introductionmentioning

confidence: 99%

Beauty and the beast: host microRNA-155 versus SARS-CoV-2

Papadopoulos

Papadopoulou

2023

Human Cell

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Severe acute respiratory coronavirus 2 (SARS-CoV-2) infection in the young and healthy usually results in an asymptomatic or mild viral syndrome, possibly through an erythropoietin (EPO)-dependent, protective evolutionary landscape. In the old and in the presence of co-morbidities, however, a potentially lethal coronavirus disease 2019 (COVID-19) cytokine storm, through unrestrained renin-angiotensin aldosterone system (RAAS) hyperactivity, has been described. Multifunctional microRNA-155 (miR-155) elevation in malaria, dengue virus (DENV), the thalassemias, and SARS-CoV-1/2, plays critical antiviral and cardiovascular roles through its targeted translational repression of over 140 genes. In the present review, we propose a plausible miR-155-dependent mechanism whereby the translational repression of AGRT1 , Arginase-2 and Ets-1 , reshapes RAAS towards Angiotensin II (Ang II) type 2 (AT2R)-mediated balanced, tolerable, and SARS-CoV-2-protective cardiovascular phenotypes. In addition, it enhances EPO secretion and endothelial nitric oxide synthase activation and substrate availability, and negates proinflammatory Ang II effects. Disrupted miR-155 repression of AT1R + 1166C-allele, significantly associated with adverse cardiovascular and COVID-19 outcomes, manifests its decisive role in RAAS modulation. BACH1 and SOCS1 repression creates an anti-inflammatory and cytoprotective milieu, robustly inducing antiviral interferons. MiR-155 dysregulation in the elderly, and in comorbidities, allows unimpeded RAAS hyperactivity to progress towards a particularly aggressive COVID-19 course. Elevated miR-155 in thalassemia plausibly engenders a favorable cardiovascular profile and protection against malaria, DENV, and SARS-CoV-2. MiR-155 modulating pharmaceutical approaches could offer novel therapeutic options in COVID-19.

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Effects of Angiotensin II Receptor Blockers on the Risk of Mortality in Patients with COVID-19: An Updated Systematic Review and Meta-analysis of Randomized Trials

Cited by 2 publications

References 4 publications

Telmisartan and losartan: The marked differences between their chemical and pharmacological properties may explain the difference in therapeutic efficacy in hospitalized patients with COVID‐19

Telmisartan and losartan: The marked differences between their chemical and pharmacological properties may explain the difference in therapeutic efficacy in hospitalized patients with COVID‐19

Beauty and the beast: host microRNA-155 versus SARS-CoV-2

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