ACE inhibitors, angiotensin receptor blockers and endothelial injury in COVID-19.

Journal of Internal Medicine
S TetlowP Roberts

Abstract

COVID-19 is caused by the coronavirus SARS-CoV-2, which uses angiotensin-converting enzyme 2 (ACE-2) as a receptor for cellular entry. It is theorized that ACE inhibitors (ACE-Is) or angiotensin receptor blockers (ARBs) may increase vulnerability to SARS-CoV-2 by upregulating ACE-2 expression, but ACE-I/ARB discontinuation is associated with clinical deterioration. To determine whether ACE-I and ARB use is associated with acute kidney injury (AKI), macrovascular thrombosis and in-hospital mortality. A retrospective, single-centre study of 558 hospital inpatients with confirmed COVID-19 admitted from 1 March to 30 April 2020, followed up until 24 May 2020. AKI and macrovascular thrombosis were primary end-points, and in-hospital mortality was a secondary end-point. AKI occurred in 126 (23.1%) patients, 34 (6.1%) developed macrovascular thrombi, and 200 (35.9%) died. Overlap propensity score-weighted analysis showed no significant effect of ACE-I/ARB use on the risk of occurrence of the specified end-points. On exploratory analysis, severe chronic kidney disease (CKD) increases odds of macrovascular thrombi (OR: 8.237, 95% CI: 1.689-40.181, P = 0.009). The risk of AKI increased with advancing age (OR: 1.028, 95% CI: 1.011-1.044, ...Continue Reading

References

Jan 27, 2004·American Journal of Epidemiology·J KarlbergW Y Y Lai
Apr 19, 2005·American Journal of Physiology. Heart and Circulatory Physiology·Michiya IgaseCarlos M Ferrario
Jul 8, 2005·Nature·Yumiko ImaiJosef M Penninger
Aug 11, 2007·The Journal of Surgical Research·Shanglong YaoLikui Wang
Nov 14, 2008·American Journal of Physiology. Renal Physiology·María José SolerDaniel Batlle
Aug 11, 2011·Molecular and Cellular Endocrinology·Arun Prasath LakshmananMakoto Kodama
May 23, 2012·International Journal of Vascular Medicine·Gopi Krishna KolluruChristopher G Kevil
Dec 24, 2014·Amino Acids·Raphael N Vuille-dit-BilleFrançois Verrey
Jul 22, 2016·JAMA Cardiology·Jennifer L NguyenPatrick L Kinney
Feb 8, 2020·JAMA : the Journal of the American Medical Association·Dawei WangZhiyong Peng
Mar 15, 2020·The Lancet. Respiratory Medicine·Lei FangMichael Roth
Mar 28, 2020·Circulation·Kaiming WangGavin Y Oudit
Apr 16, 2020·European Heart Journal·Luka NicinStefanie Dimmeler
Apr 21, 2020·Journal of the American College of Cardiology·Behnood BikdeliUNKNOWN Global COVID-19 Thrombosis Collaborative Group, Endorsed by the ISTH, NATF, ESVM, and the IUA, Supported by the ESC Working
Apr 24, 2020·Lancet·Zsuzsanna VargaHolger Moch
Apr 28, 2020·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Sara TedeschiPierluigi Viale
May 2, 2020·The New England Journal of Medicine·Harmony R ReynoldsJudith S Hochman
May 22, 2020·The New England Journal of Medicine·Maximilian AckermannDanny Jonigk
May 23, 2020·Nature Reviews. Immunology·Laure-Anne TeuwenPeter Carmeliet
Jul 9, 2020·Nature·Elizabeth J WilliamsonBen Goldacre
Aug 28, 2020·Nature·Takehiro TakahashiAkiko Iwasaki

❮ Previous
Next ❯

Citations

Mar 9, 2021·Frontiers in Physiology·Jing-Yi QianBi-Cheng Liu
Jul 30, 2021·Journal of the American Heart Association·Jordan LoaderJohan Sundström
Aug 28, 2021·Biomedicines·Francesco NappiSanjeet Singh Avtaar Singh

❮ Previous
Next ❯

Methods Mentioned

BETA
PCR
lavage

Clinical Trials Mentioned

NCT04355429
NCT04311177
NCT04312009

Software Mentioned

R

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.