Mortality and disease severity among COVID-19 patients with hypertension receiving renin-angiotensin system inhibitors

Hasan, Syed Shahzad; Kow, Chia Siang; Merchant, Hamid A.

doi:10.22541/au.158880148.84250526

Cited by 3 publications

(1 citation statement)

References 21 publications

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“…Rosuvastatin is a drug of statin class that has a role in lowering the lipid so it used to decrease the incidence of cardiovascular diseases and control elevated levels of lipid by inhibiting the liver from the production of endogenous cholesterol . Rosuvastatin can also used as antioxidant, antiinflammatory, stabilizer for ion channel, and regulator for autonomic nervous system (Hasan and Kow, 2020). There is substantial evidence supporting the use of statins in COVID-19 patients.…”

Section: Discussionmentioning

confidence: 99%

A prospective clinical study to compare between the role of Rosuvastatin against Nigella Sativa (N sativa) in protection of azithromycin toxicity in covid-19 patients in isolation centers, Minia Governorate, Egypt

Hafez¹,

Azeem²,

Magid³

et al. 2023

Ain Shams Journal of Forensic Medicine and Clinical Toxicology

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Background: Azithromycin is the most common antibiotic used nowadays. Objectives: To evaluate the cardio-toxicity of azithromycin and to assess the effect of Nigella Sativa (N Sativa) and Rosuvastatin in cardio-protection. Patient & methods: This clinical prospective study was carried out on adult patients diagnosed as positive COVID-19 and was admitted to isolation centers in Minia Governorate during the period from 1 st of June 2021 to 30 th of May 2022. It included 160 patients divided into 4 groups. Group I received 500 mg/ 24 hours (hrs) of azithromycin orally for five days, group II received 500 mg/ 24hrs of azithromycin + 20 mg/ day of Rosuvastatin orally for five days, group III also received 500 mg/ 24hrs of azithromycin + 4 mg/ kg/ 24hrs N Sativa orally for five days, group IV received the same previously mentioned doses and duration of azithromycin, Rosuvastatin and N Sativa. Full clinical examination was done, electrocardiogram (ECG) was performed and venous blood samples were drawn for estimation of CK-MB level from all patients before and after the treatment. Result: Patients aged 32-59 years old, 62 were females and 98 were males. Significant elevation of CK-MB in group I after treatment with azithromycin comparing with before treatment in the same group (p<0.01) was detected. There were significant differences in all groups between pre and posttreatment regards QT interval (p<0.01). Conclusion: Azithromycin had toxic effect on the heart, Rosuvastatin was better than N Sativa in treating this toxic effect. Treatment with Rosuvastatin + N Sativa together leads to the best results. Recommendation of this study is taking of Rosuvastatin plus N Sativa during the treatment with azithromycin.

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Section: Discussionmentioning

confidence: 99%

A prospective clinical study to compare between the role of Rosuvastatin against Nigella Sativa (N sativa) in protection of azithromycin toxicity in covid-19 patients in isolation centers, Minia Governorate, Egypt

Hafez¹,

Azeem²,

Magid³

et al. 2023

Ain Shams Journal of Forensic Medicine and Clinical Toxicology

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An umbrella review and meta-analysis of the use of renin-angiotensin system drugs and COVID-19 outcomes: what do we know so far?

Kurdi

Weir

Mueller

2022

Preprint

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BackgroundsEvidence from several meta-analyses are still controversial about the effects of angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin-receptor blockers (ARBs) on COVID-19 outcomes.PurposeUmbrella review of systematic reviews/meta-analysis to provide comprehensive assessment of the effect of ACEIs/ARBs on COVID-19 related outcomes by summarising the currently available evidence.Data SourceMedline (OVID), Embase, Scopus, Cochrane library and medRxiv from inception to 1st February 2021.Study SelectionSystematic reviews with meta-analysis that evaluated the effect of ACEIs/ARBs on COVID-19 related clinical outcomesData ExtractionTwo reviewers independently extracted the data and assessed studies’ risk of bias using AMSTAR 2 Critical Appraisal Tool.Data SynthesisPooled estimates were combined using the random-effects meta-analyses model including several sub-group analyses. Overall, 47 reviews were eligible for inclusion. Out of the nine COVID-19 outcomes evaluated, there was significant associations between ACEIs/ARBs use and each of death (OR=0.80, 95%CI=0.75-0.86; I2=51.9%), death/ICU admission as composite outcome (OR=0.86, 95%CI=0.80-0.92; I2=43.9%), severe COVID-19 (OR=0.86, 95%CI=0.78-0.95; I2=68%), and hospitalisation (OR=1.23, 95%CI=1.04-1.46; I2= 76.4%). The significant reduction in death/ICU admission, however, was higher among studies which presented adjusted measure of effects (OR=0.63, 95%CI=0.47-0.84) and were of moderate quality (OR=0.74, 95%CI=0.63-0.85).LimitationsThe effect of unmeasured confounding could not be ruled out. Only 21.3% (n=10) of the studies were of ‘moderate’ quality.ConclusionCollective evidence from observational studies indicate a good quality evidence on the significant association between ACEIs/ARBs use and reduction in death and death/ICU admission, but poor-quality evidence on both reducing severe COVID-19 and increasing hospitalisation. Our findings further support the current recommendations of not discontinuing ACEIs/ARBs therapy in patients with COVID-19.RegistrationThe study protocol was registered in PROSPERO (CRD42021233398).Funding SourceNone

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Coronavirus Disease (COVID-19): Comprehensive Review of Clinical Presentation

Mehta

Bhandari

Raut

et al. 2021

Front. Public Health

160

136

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COVID-19 is a rapidly growing pandemic with its first case identified during December 2019 in Wuhan, Hubei Province, China. Due to the rampant rise in the number of cases in China and globally, WHO declared COVID-19 as a pandemic on 11th March 2020. The disease is transmitted via respiratory droplets of infected patients during coughing or sneezing and affects primarily the lung parenchyma. The spectrum of clinical manifestations can be seen in COVID-19 patients ranging from asymptomatic infections to severe disease resulting in mortality. Although respiratory involvement is most common in COVID-19 patients, the virus can affect other organ systems as well. The systemic inflammation induced by the disease along with multisystem expression of Angiotensin Converting Enzyme 2 (ACE2), a receptor which allows viral entry into cells, explains the manifestation of extra-pulmonary symptoms affecting the gastrointestinal, cardiovascular, hematological, renal, musculoskeletal, and endocrine system. Here, we have reviewed the extensive literature available on COVID-19 about various clinical presentations based on the organ system involved as well as clinical presentation in specific population including children, pregnant women, and immunocompromised patients. We have also briefly discussed about the Multisystemic Inflammatory Syndrome occurring in children and adults with COVID-19. Understanding the various clinical presentations can help clinicians diagnose COVID-19 in an early stage and ensure appropriate measures to be undertaken in order to prevent further spread of the disease.

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Mortality and disease severity among COVID-19 patients with hypertension receiving renin-angiotensin system inhibitors

Cited by 3 publications

References 21 publications

A prospective clinical study to compare between the role of Rosuvastatin against Nigella Sativa (N sativa) in protection of azithromycin toxicity in covid-19 patients in isolation centers, Minia Governorate, Egypt

A prospective clinical study to compare between the role of Rosuvastatin against Nigella Sativa (N sativa) in protection of azithromycin toxicity in covid-19 patients in isolation centers, Minia Governorate, Egypt

An umbrella review and meta-analysis of the use of renin-angiotensin system drugs and COVID-19 outcomes: what do we know so far?

Coronavirus Disease (COVID-19): Comprehensive Review of Clinical Presentation

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