Covid-19 and cardiovascular risk: Susceptibility to infection to SARS-CoV-2, severity and prognosis of Covid-19 and blockade of the renin-angiotensin-aldosterone system. An evidence-based viewpoint.
Identifieur interne : 000097 ( Main/Corpus ); précédent : 000096; suivant : 000098Covid-19 and cardiovascular risk: Susceptibility to infection to SARS-CoV-2, severity and prognosis of Covid-19 and blockade of the renin-angiotensin-aldosterone system. An evidence-based viewpoint.
Auteurs : Francesco P. Cappuccio ; Alfonso SianiSource :
- Nutrition, metabolism, and cardiovascular diseases : NMCD [ 1590-3729 ] ; 2020.
English descriptors
- KwdEn :
- Aged (MeSH), Angiotensin Receptor Antagonists (therapeutic use), Angiotensin-Converting Enzyme Inhibitors (therapeutic use), Betacoronavirus (MeSH), Cardiovascular Diseases (complications), Coronavirus Infections (etiology), Coronavirus Infections (mortality), Humans (MeSH), Middle Aged (MeSH), Pandemics (MeSH), Pneumonia, Viral (etiology), Pneumonia, Viral (mortality), Prognosis (MeSH), Renin-Angiotensin System (physiology).
- MESH :
- chemical , therapeutic use : Angiotensin Receptor Antagonists, Angiotensin-Converting Enzyme Inhibitors.
- complications : Cardiovascular Diseases.
- etiology : Coronavirus Infections, Pneumonia, Viral.
- mortality : Coronavirus Infections, Pneumonia, Viral.
- physiology : Renin-Angiotensin System.
- Aged, Betacoronavirus, Humans, Middle Aged, Pandemics, Prognosis.
Abstract
The presence of cardiovascular co-morbidities and the known effects of coronaviruses on the cardiovascular system have called attention to the potential implications for patients with cardiovascular risk factors. This evidence-based viewpoint will address two questions: (a) are individuals with underlying cardiovascular risk factors (e.g. high blood pressure or diabetes) or overt disease (e.g. coronary heart disease, heart failure, kidney disease) more likely to develop severe Covid-19 and to die than those without underlying conditions? (b) does the regular use of angiotensin-converting enzyme inhibitors (ACE-i) or angiotensin-receptor blockers (ARB) make patients more likely to get infected and to die of Covid-19? With a necessary cautionary note that the evidence around the links between Covid-19 and cardiovascular disease is accruing at a fast pace, to date we can conclude that: (a) the greater susceptibility of individuals with underlying cardiovascular conditions to develop more severe Covid-19 with higher mortality rate is likely to be confounded, in part, by age and the type of co-morbidities. Patients with heart failure or chronic kidney disease might show an excess risk; (b) neither ACE-i nor ARB are associated with greater risk of SARS-Cov2 infection, or severity or risk of death in patients with Covid-19. Patients on these drugs should not stop them, unless under strict medical supervision and with the addition of a suitable replacement medicine.
DOI: 10.1016/j.numecd.2020.05.013
PubMed: 32595085
PubMed Central: PMC7256508
Links to Exploration step
pubmed:32595085Le document en format XML
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<author><name sortKey="Cappuccio, Francesco P" sort="Cappuccio, Francesco P" uniqKey="Cappuccio F" first="Francesco P" last="Cappuccio">Francesco P. Cappuccio</name>
<affiliation><nlm:affiliation>University of Warwick, Warwick Medical School, Coventry, UK; University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK. Electronic address: f.p.cappuccio@warwick.ac.uk.</nlm:affiliation>
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<author><name sortKey="Siani, Alfonso" sort="Siani, Alfonso" uniqKey="Siani A" first="Alfonso" last="Siani">Alfonso Siani</name>
<affiliation><nlm:affiliation>Institute of Food Sciences, CNR, Avellino, Italy.</nlm:affiliation>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">Covid-19 and cardiovascular risk: Susceptibility to infection to SARS-CoV-2, severity and prognosis of Covid-19 and blockade of the renin-angiotensin-aldosterone system. An evidence-based viewpoint.</title>
<author><name sortKey="Cappuccio, Francesco P" sort="Cappuccio, Francesco P" uniqKey="Cappuccio F" first="Francesco P" last="Cappuccio">Francesco P. Cappuccio</name>
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<author><name sortKey="Siani, Alfonso" sort="Siani, Alfonso" uniqKey="Siani A" first="Alfonso" last="Siani">Alfonso Siani</name>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged (MeSH)</term>
<term>Angiotensin Receptor Antagonists (therapeutic use)</term>
<term>Angiotensin-Converting Enzyme Inhibitors (therapeutic use)</term>
<term>Betacoronavirus (MeSH)</term>
<term>Cardiovascular Diseases (complications)</term>
<term>Coronavirus Infections (etiology)</term>
<term>Coronavirus Infections (mortality)</term>
<term>Humans (MeSH)</term>
<term>Middle Aged (MeSH)</term>
<term>Pandemics (MeSH)</term>
<term>Pneumonia, Viral (etiology)</term>
<term>Pneumonia, Viral (mortality)</term>
<term>Prognosis (MeSH)</term>
<term>Renin-Angiotensin System (physiology)</term>
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<term>Angiotensin-Converting Enzyme Inhibitors</term>
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<keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Cardiovascular Diseases</term>
</keywords>
<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Coronavirus Infections</term>
<term>Pneumonia, Viral</term>
</keywords>
<keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Coronavirus Infections</term>
<term>Pneumonia, Viral</term>
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<keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Renin-Angiotensin System</term>
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<keywords scheme="MESH" xml:lang="en"><term>Aged</term>
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<front><div type="abstract" xml:lang="en">The presence of cardiovascular co-morbidities and the known effects of coronaviruses on the cardiovascular system have called attention to the potential implications for patients with cardiovascular risk factors. This evidence-based viewpoint will address two questions: (a) are individuals with underlying cardiovascular risk factors (e.g. high blood pressure or diabetes) or overt disease (e.g. coronary heart disease, heart failure, kidney disease) more likely to develop severe Covid-19 and to die than those without underlying conditions? (b) does the regular use of angiotensin-converting enzyme inhibitors (ACE-i) or angiotensin-receptor blockers (ARB) make patients more likely to get infected and to die of Covid-19? With a necessary cautionary note that the evidence around the links between Covid-19 and cardiovascular disease is accruing at a fast pace, to date we can conclude that: (a) the greater susceptibility of individuals with underlying cardiovascular conditions to develop more severe Covid-19 with higher mortality rate is likely to be confounded, in part, by age and the type of co-morbidities. Patients with heart failure or chronic kidney disease might show an excess risk; (b) neither ACE-i nor ARB are associated with greater risk of SARS-Cov2 infection, or severity or risk of death in patients with Covid-19. Patients on these drugs should not stop them, unless under strict medical supervision and with the addition of a suitable replacement medicine.</div>
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<Abstract><AbstractText>The presence of cardiovascular co-morbidities and the known effects of coronaviruses on the cardiovascular system have called attention to the potential implications for patients with cardiovascular risk factors. This evidence-based viewpoint will address two questions: (a) are individuals with underlying cardiovascular risk factors (e.g. high blood pressure or diabetes) or overt disease (e.g. coronary heart disease, heart failure, kidney disease) more likely to develop severe Covid-19 and to die than those without underlying conditions? (b) does the regular use of angiotensin-converting enzyme inhibitors (ACE-i) or angiotensin-receptor blockers (ARB) make patients more likely to get infected and to die of Covid-19? With a necessary cautionary note that the evidence around the links between Covid-19 and cardiovascular disease is accruing at a fast pace, to date we can conclude that: (a) the greater susceptibility of individuals with underlying cardiovascular conditions to develop more severe Covid-19 with higher mortality rate is likely to be confounded, in part, by age and the type of co-morbidities. Patients with heart failure or chronic kidney disease might show an excess risk; (b) neither ACE-i nor ARB are associated with greater risk of SARS-Cov2 infection, or severity or risk of death in patients with Covid-19. Patients on these drugs should not stop them, unless under strict medical supervision and with the addition of a suitable replacement medicine.</AbstractText>
<CopyrightInformation>Copyright © 2020 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.</CopyrightInformation>
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<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Cappuccio</LastName>
<ForeName>Francesco P</ForeName>
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<AffiliationInfo><Affiliation>University of Warwick, Warwick Medical School, Coventry, UK; University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK. Electronic address: f.p.cappuccio@warwick.ac.uk.</Affiliation>
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<CoiStatement>Declaration of Competing Interest No conflict of interest to declare.</CoiStatement>
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