Comorbidities in COVID-19: Outcomes in hypertensive cohort and controversies with renin angiotensin system blockers.
Identifieur interne : 000007 ( Main/Exploration ); précédent : 000006; suivant : 000008Comorbidities in COVID-19: Outcomes in hypertensive cohort and controversies with renin angiotensin system blockers.
Auteurs : Awadhesh Kumar Singh [Inde] ; Ritesh Gupta [Inde] ; Anoop Misra [Inde]Source :
- Diabetes & metabolic syndrome [ 1878-0334 ]
Descripteurs français
- KwdFr :
- Animaux (MeSH), Antagonistes des récepteurs aux angiotensines (effets indésirables), Antagonistes des récepteurs aux angiotensines (usage thérapeutique), Antihypertenseurs (effets indésirables), Antihypertenseurs (usage thérapeutique), Betacoronavirus (MeSH), Chine (épidémiologie), Comorbidité (MeSH), Diabète (épidémiologie), Humains (MeSH), Hypertension artérielle (traitement médicamenteux), Hypertension artérielle (épidémiologie), Infections à coronavirus (mortalité), Infections à coronavirus (épidémiologie), Inhibiteurs de l'enzyme de conversion de l'angiotensine (effets indésirables), Inhibiteurs de l'enzyme de conversion de l'angiotensine (usage thérapeutique), Maladies cardiovasculaires (épidémiologie), Pandémies (MeSH), Peptidyl-Dipeptidase A (physiologie), Pneumopathie virale (mortalité), Pneumopathie virale (épidémiologie), PubMed (MeSH), Souris (MeSH), Système rénine-angiotensine (effets des médicaments et des substances chimiques), Système rénine-angiotensine (physiologie).
- MESH :
- effets des médicaments et des substances chimiques : Système rénine-angiotensine.
- effets indésirables : Antagonistes des récepteurs aux angiotensines, Antihypertenseurs, Inhibiteurs de l'enzyme de conversion de l'angiotensine.
- mortalité : Infections à coronavirus, Pneumopathie virale.
- physiologie : Peptidyl-Dipeptidase A, Système rénine-angiotensine.
- traitement médicamenteux : Hypertension artérielle.
- usage thérapeutique : Antagonistes des récepteurs aux angiotensines, Antihypertenseurs, Inhibiteurs de l'enzyme de conversion de l'angiotensine.
- épidémiologie : Chine, Diabète, Hypertension artérielle, Infections à coronavirus, Maladies cardiovasculaires, Pneumopathie virale.
- Animaux, Betacoronavirus, Comorbidité, Humains, Pandémies, PubMed, Souris.
- Wicri :
- geographic : République populaire de Chine.
English descriptors
- KwdEn :
- Angiotensin Receptor Antagonists (adverse effects), Angiotensin Receptor Antagonists (therapeutic use), Angiotensin-Converting Enzyme Inhibitors (adverse effects), Angiotensin-Converting Enzyme Inhibitors (therapeutic use), Animals (MeSH), Antihypertensive Agents (adverse effects), Antihypertensive Agents (therapeutic use), Betacoronavirus (MeSH), Cardiovascular Diseases (epidemiology), China (epidemiology), Comorbidity (MeSH), Coronavirus Infections (epidemiology), Coronavirus Infections (mortality), Diabetes Mellitus (epidemiology), Humans (MeSH), Hypertension (drug therapy), Hypertension (epidemiology), Mice (MeSH), Pandemics (MeSH), Peptidyl-Dipeptidase A (physiology), Pneumonia, Viral (epidemiology), Pneumonia, Viral (mortality), PubMed (MeSH), Renin-Angiotensin System (drug effects), Renin-Angiotensin System (physiology).
- MESH :
- chemical , adverse effects : Angiotensin Receptor Antagonists, Angiotensin-Converting Enzyme Inhibitors, Antihypertensive Agents.
- chemical , physiology : Peptidyl-Dipeptidase A.
- chemical , therapeutic use : Angiotensin Receptor Antagonists, Angiotensin-Converting Enzyme Inhibitors, Antihypertensive Agents.
- geographic , epidemiology : China.
- drug effects : Renin-Angiotensin System.
- drug therapy : Hypertension.
- epidemiology : Cardiovascular Diseases, Coronavirus Infections, Diabetes Mellitus, Hypertension, Pneumonia, Viral.
- mortality : Coronavirus Infections, Pneumonia, Viral.
- physiology : Renin-Angiotensin System.
- Animals, Betacoronavirus, Comorbidity, Humans, Mice, Pandemics, PubMed.
Abstract
BACKGROUND 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 = 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.
DOI: 10.1016/j.dsx.2020.03.016
PubMed: 32283499
PubMed Central: PMC7144598
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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thérapeutique)</term><term>Betacoronavirus (MeSH)</term><term>Chine (épidémiologie)</term><term>Comorbidité (MeSH)</term><term>Diabète (épidémiologie)</term><term>Humains (MeSH)</term><term>Hypertension artérielle (traitement médicamenteux)</term><term>Hypertension artérielle (épidémiologie)</term><term>Infections à coronavirus (mortalité)</term><term>Infections à coronavirus (épidémiologie)</term><term>Inhibiteurs de l'enzyme de conversion de l'angiotensine (effets indésirables)</term><term>Inhibiteurs de l'enzyme de conversion de l'angiotensine (usage thérapeutique)</term><term>Maladies cardiovasculaires (épidémiologie)</term><term>Pandémies (MeSH)</term><term>Peptidyl-Dipeptidase A (physiologie)</term><term>Pneumopathie virale (mortalité)</term><term>Pneumopathie virale (épidémiologie)</term><term>PubMed (MeSH)</term><term>Souris (MeSH)</term><term>Système rénine-angiotensine (effets des médicaments et des substances chimiques)</term><term>Système rénine-angiotensine 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qualifier="physiology" xml:lang="en"><term>Renin-Angiotensin System</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Hypertension artérielle</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Antagonistes des récepteurs aux angiotensines</term><term>Antihypertenseurs</term><term>Inhibiteurs de l'enzyme de conversion de l'angiotensine</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Chine</term><term>Diabète</term><term>Hypertension artérielle</term><term>Infections à coronavirus</term><term>Maladies cardiovasculaires</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Animals</term><term>Betacoronavirus</term><term>Comorbidity</term><term>Humans</term><term>Mice</term><term>Pandemics</term><term>PubMed</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Animaux</term><term>Betacoronavirus</term><term>Comorbidité</term><term>Humains</term><term>Pandémies</term><term>PubMed</term><term>Souris</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>République populaire de Chine</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND AND AIMS</b></p><p>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).</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>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.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>From the pooled data of all ten available Chinese studies (n = 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.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>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.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32283499</PMID><DateCompleted><Year>2020</Year><Month>07</Month><Day>23</Day></DateCompleted><DateRevised><Year>2020</Year><Month>07</Month><Day>23</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1878-0334</ISSN><JournalIssue CitedMedium="Internet"><Volume>14</Volume><Issue>4</Issue><PubDate><MedlineDate>2020 Jul - Aug</MedlineDate></PubDate></JournalIssue><Title>Diabetes & metabolic syndrome</Title><ISOAbbreviation>Diabetes Metab Syndr</ISOAbbreviation></Journal><ArticleTitle>Comorbidities in COVID-19: Outcomes in hypertensive cohort and controversies with renin angiotensin system blockers.</ArticleTitle><Pagination><MedlinePgn>283-287</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S1871-4021(20)30056-4</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.dsx.2020.03.016</ELocationID><Abstract><AbstractText Label="BACKGROUND AND AIMS" NlmCategory="OBJECTIVE">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).</AbstractText><AbstractText Label="METHODS" NlmCategory="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.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">From the pooled data of all ten available Chinese studies (n = 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.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">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.</AbstractText><CopyrightInformation>Copyright © 2020 Diabetes India. Published by Elsevier Ltd. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Singh</LastName><ForeName>Awadhesh Kumar</ForeName><Initials>AK</Initials><AffiliationInfo><Affiliation>G. D Hospital & Diabetes Institute, Kolkata, India. Electronic address: draksingh_2001@yahoo.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gupta</LastName><ForeName>Ritesh</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Fortis CDOC Hospital for Diabetes and Allied Sciences, New Delhi, India.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Misra</LastName><ForeName>Anoop</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Fortis CDOC Hospital for Diabetes and Allied Sciences, New Delhi, India; National Diabetes, Obesity and Cholesterol Foundation, New Delhi, India; Diabetes Foundation (India), New Delhi, India.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D000078182">Systematic Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>04</Month><Day>09</Day></ArticleDate></Article><MedlineJournalInfo><Country>Netherlands</Country><MedlineTA>Diabetes Metab Syndr</MedlineTA><NlmUniqueID>101462250</NlmUniqueID><ISSNLinking>1871-4021</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D057911">Angiotensin Receptor Antagonists</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000806">Angiotensin-Converting Enzyme Inhibitors</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000959">Antihypertensive Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>EC 3.4.15.1</RegistryNumber><NameOfSubstance UI="D007703">Peptidyl-Dipeptidase A</NameOfSubstance></Chemical><Chemical><RegistryNumber>EC 3.4.17.-</RegistryNumber><NameOfSubstance UI="C413524">angiotensin converting enzyme 2</NameOfSubstance></Chemical></ChemicalList><SupplMeshList><SupplMeshName Type="Disease" UI="C000657245">COVID-19</SupplMeshName><SupplMeshName Type="Organism" UI="C000656484">severe acute respiratory syndrome coronavirus 2</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D057911" MajorTopicYN="N">Angiotensin Receptor Antagonists</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000806" MajorTopicYN="N">Angiotensin-Converting Enzyme Inhibitors</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000818" MajorTopicYN="N">Animals</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000959" MajorTopicYN="N">Antihypertensive Agents</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="Y">Betacoronavirus</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002318" MajorTopicYN="N">Cardiovascular Diseases</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002681" MajorTopicYN="N" Type="Geographic">China</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015897" MajorTopicYN="Y">Comorbidity</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName><QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003920" MajorTopicYN="N">Diabetes Mellitus</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006973" MajorTopicYN="N">Hypertension</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D051379" MajorTopicYN="N">Mice</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="N">Pandemics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007703" MajorTopicYN="N">Peptidyl-Dipeptidase A</DescriptorName><QualifierName UI="Q000502" MajorTopicYN="N">physiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011024" MajorTopicYN="N">Pneumonia, Viral</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName><QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D039781" MajorTopicYN="N">PubMed</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012084" MajorTopicYN="N">Renin-Angiotensin System</DescriptorName><QualifierName UI="Q000187" MajorTopicYN="Y">drug effects</QualifierName><QualifierName UI="Q000502" MajorTopicYN="N">physiology</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Angiotensin-converting enzyme inhibitors</Keyword><Keyword MajorTopicYN="N">Angiotensin-receptor blockers</Keyword><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">Comorbidities</Keyword><Keyword MajorTopicYN="N">Hypertension</Keyword></KeywordList><CoiStatement>Declaration of competing interest We hereby declare that we have no conflict of interest related to this article.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>03</Month><Day>28</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>03</Month><Day>28</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>4</Month><Day>14</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>7</Month><Day>24</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>4</Month><Day>14</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32283499</ArticleId><ArticleId IdType="pii">S1871-4021(20)30056-4</ArticleId><ArticleId IdType="doi">10.1016/j.dsx.2020.03.016</ArticleId><ArticleId IdType="pmc">PMC7144598</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Inde</li></country></list><tree><country name="Inde"><noRegion><name sortKey="Singh, Awadhesh Kumar" sort="Singh, Awadhesh Kumar" uniqKey="Singh A" first="Awadhesh Kumar" last="Singh">Awadhesh Kumar Singh</name></noRegion><name sortKey="Gupta, Ritesh" sort="Gupta, Ritesh" uniqKey="Gupta R" first="Ritesh" last="Gupta">Ritesh Gupta</name><name sortKey="Misra, Anoop" sort="Misra, Anoop" uniqKey="Misra A" first="Anoop" last="Misra">Anoop Misra</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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