Should COVID-19 Concern Nephrologists? Why and to What Extent? The Emerging Impasse of Angiotensin Blockade

Perico, Luca; Benigni, Ariela; Remuzzi, Giuseppe

doi:10.1159/000507305

Cited by 290 publications

(377 citation statements)

References 55 publications

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“…Thus, raised sympathetic activity leads to myocardial injury and ARDS by pulmonary capillary leakage. On the other hand, it has been reported in a limited number of animal studies that angiotensin 1-7 intravenous or intraperitoneal administration is useful in ARDS treatment [1]. We speculate that ARBs may be dangerous as it increases the ACE2 level in the brain and heart tissue.…”

Section: Dear Editormentioning

confidence: 79%

“…Angiotensin II may increase pulmonary vascular leakage, causing lung injury during COVID-19 infection. The authors claimed that ARBs could alter the ACE2 structure [1]. However, according to the current literature, there is no information that ARBs change the structure of ACE2.…”

Section: Dear Editormentioning

confidence: 99%

“…We read with great interest the review article by Perico et al [1] "Should COVID-19 Concern Nephrologists? Why and to What Extent?…”

Section: Dear Editormentioning

confidence: 99%

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Comment on “Should COVID-19 Concern Nephrologists? Why and to What Extent? The Emerging Impasse of Angiotensin Blockade”

Cüre¹,

Cüre²

2020

Nephron

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Section: Dear Editormentioning

confidence: 79%

Section: Dear Editormentioning

confidence: 99%

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Comment on “Should COVID-19 Concern Nephrologists? Why and to What Extent? The Emerging Impasse of Angiotensin Blockade”

Cüre¹,

Cüre²

2020

Nephron

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“…The exact mechanism of apparent benefit of these drugs in coronavirus infection is not yet clear. However, there could be several explanations [42]. i.…”

Section: Effects Of Ace Inhibitors and Angiotensin Receptor Blockersmentioning

confidence: 99%

Comorbidities in COVID-19: Outcomes in hypertensive cohort and controversies with renin angiotensin system blockers

Singh

Gupta

Misra

2020

Diabetes & Metabolic Syndrome: Clinical Research & Revi

220

156

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a b s t r a c tBackground and aims: COVID-19 is already a pandemic. Emerging data suggest an increased association and a heightened mortality in patients of COVID-19 with comorbidities. We aimed to evaluate the outcome in hypertensive patients with COVID-19 and its relation to the use of renin-angiotensin system blockers (RASB). Methods: We have systematically searched the medical database up to March 27, 2020 and retrieved all the published articles in English language related to our topic using MeSH key words. Results: From the pooled data of all ten available Chinese studies (n ¼ 2209) that have reported the characteristics of comorbidities in patients with COVID-19, hypertension was present in nearly 21%, followed by diabetes in nearly 11%, and established cardiovascular disease (CVD) in approximately 7% of patients. Although the emerging data hints to an increase in mortality in COVID-19 patients with known hypertension, diabetes and CVD, it should be noted that it was not adjusted for multiple confounding factors. Harm or benefit in COVID-19 patients receiving RASB has not been typically assessed in these studies yet, although mechanistically and plausibly both, benefit and harm is possible with these agents, given that COVID-19 expresses to tissues through the receptor of angiotensin converting enzyme-2. Conclusion: Special attention is definitely required in patients with COVID-19 with associated comorbidities including hypertension, diabetes and established CVD. Although the role of RASB has a mechanistic equipoise, patients with COVID-19 should not stop these drugs at this point of time, as recommended by various world organizations and without the advice of health care provider.

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“…In this issue of Nephron, Perico, Benigni, and Remuzzi offer a concise overview of the interactions of the SARS-CoV-2 virus, the angiotensin-converting enzyme (ACE) pathway(s), and the cell surface glycoprotein ACE2, and describe the mechanism of cellular SARS-CoV-2 uptake via the endocytosis-lysosomal pathway [1].…”

mentioning

confidence: 99%

Clinical Trials during the SARS-CoV-2 Pandemic

Warnock¹

2020

Nephron

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Should COVID-19 Concern Nephrologists? Why and to What Extent? The Emerging Impasse of Angiotensin Blockade

Cited by 290 publications

References 55 publications

Comment on “Should COVID-19 Concern Nephrologists? Why and to What Extent? The Emerging Impasse of Angiotensin Blockade”

Comment on “Should COVID-19 Concern Nephrologists? Why and to What Extent? The Emerging Impasse of Angiotensin Blockade”

Comorbidities in COVID-19: Outcomes in hypertensive cohort and controversies with renin angiotensin system blockers

Clinical Trials during the SARS-CoV-2 Pandemic

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