Effect of clinical progress in antihypertensive medications among COVID-19 patients Antihypertensive medications among COVID-19 patients
Article Sidebar
Main Article Content
Abstract
Objective: Many chronic diseases, such as hypertension, diabetes, and coronary heart disease, paving the way for the disease to progress unfavorably in Covid-19. Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin-2 receptor blockers (ARBs) can upregulate ACE2 receptors (which SARS-COV-2 uses to enter the host cell) or protect against infection by limiting the effects of Angiotensin 2. This study aimed to reveal the impact of antihypertensive drugs on the hospital staying, and mortality in Covid-19 patients followed in the hospital.
Methods and Results: One hundred patients were randomly selected with hypertension, diabetes mellitus and coronary artery disease hospitalized in Kayseri City Training and Research Hospital due to Covid-19 infection. Patients were grouped as taking ACEIs and ARBs group and not taking ACEIs and ARBs group. There were no differences among the groups in terms of the frequency of chronic disease and treatment modalities. The length of the hospital stays, bedding into the Intensive Care Unit (ICU), and mortality rates were higher in the group without ACEIs or ARBs. Mortality was significantly lower among patients who used ACEIs and ARBs (P=0.00, P=0.02, respectively) and incredibly high among beta-blocker users (P=0.00). It was found that the advanced age, male gender and use of beta-blockers were associated with mortality.
Conclusion: Although antihypertensive medications are allegedly associated with increased mortality rates, the risk of mortality has not been detected in people taking ACEIs and ARBs. Further studies involving a greater number of patients are needed.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Accepted 2022-10-22
Published 2022-10-24
References
Wu Z, McGoogan JM. Characteristics of and Important Lessons from the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020 Apr 7;323(13): 1239-1. DOI: https://doi.org/10.1001/jama.2020.2648
Liu J, Zheng X, Tong Q, et al. Overlapping and discrete aspects of the pathology and pathogenesis of the emerging human pathogenic coronaviruses SARS-CoV, MERS-CoV, and 2019- nCoV. J Med Virol. 2020 May; 92(5):491-494. DOI: https://doi.org/10.1002/jmv.25709
Kuba, K., Imai, Y., Rao, S., et al. (2005). A crucial role of angiotensin converting enzyme 2 (ACE2) in SARS coronavirus–induced lung injury. Nature medicine, 11(8), 875-879.. DOI: https://doi.org/10.1038/nm1267
Baral, R., Tsampasian, V., Debski, et al. (2021). Association between renin-angiotensin-aldosterone system inhibitors and clinical outcomes in patients with COVID-19: a systematic review and meta-analysis. J. DOI: https://doi.org/10.1001/jamanetworkopen.2021.3594
Zhang, P., Zhu, L., Cai, J., et al. (2020). Association of inpatient use of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers with mortality among patients with hypertension hospitalized with. DOI: https://doi.org/10.1161/CIRCRESAHA.120.317242
Armstrong K, Soltoff A, Rieu-Werden M et al. Use of angiotensin converting enzyme inhibitors and angiotensin receptor blockers associated with lower risk of COVID-19 in household contacts. PLoS One. 2021 Mar 2;16(3):e0247548. DOI: https://doi.org/10.1371/journal.pone.0247548
Wang, W., Zhao, X., Wei, W., et al. (2021). Angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARBs) may be safe for COVID-19 patients. BMC infectious diseases, 21(1), 1-8.. DOI: https://doi.org/10.1186/s12879-021-05821-5
Lubel J, Garg M. Renin-Angiotensin-Aldosterone System Inhibitors in Covid-19. N Engl J Med. 2020 Jun 11;382(24): e92. DOI: https://doi.org/10.1056/NEJMc2013707
Vasanthakumar N. Beta-Adrenergic Blockers as a Potential Treatment for COVID-19 Patients. Bioessays. 2020 Nov;42(11):e2000094. DOI: https://doi.org/10.1002/bies.202000094
Al-Kuraishy, Al-Gareeb, Mostafa-Hedeab, et al. (2021). Effects of β-Blockers on the Sympathetic and Cytokines Storms in Covid-19. Frontiers in Immunology, 12. DOI: https://doi.org/10.3389/fimmu.2021.749291
Clemente-Moragón, A., Martínez-Milla, J., Oliver, E., et al. (2021). Metoprolol in critically ill patients with COVID-19. Journal of the American College of Cardiology, 78(10), 1001-1011. DOI: https://doi.org/10.1016/j.jacc.2021.07.003
Palaiodimos, L., Kokkinidis, Li, W., Karamanis, D., et al. (2020). Severe obesity, increasing age and male sex are independently associated with worse in-hospital outcomes, and higher in-hospital mortality. DOI: https://doi.org/10.1016/j.metabol.2020.154262
Cecconi, M., Piovani, D., Brunetta, E., et al. (2020). Early predictors of clinical deterioration in a cohort of 239 patients hospitalized for Covid-19 infection in Lombardy, Italy. Journal of clinical med. DOI: https://doi.org/10.3390/jcm9051548
Tomar B, Anders HJ, Desai J, et al. Neutrophils and Neutrophil Extracellular Traps Drive Necroinflammation in COVID-19. Cells. 2020 Jun 2;9(6):1383. DOI: https://doi.org/10.3390/cells9061383
Li, C., Hu, B., Zhang, Z., et al. (2020). D‐dimer triage for COVID‐19. Academic Emergency Medicine, 27(7), 612-613. DOI: https://doi.org/10.1111/acem.14037