Outcomes in Patients with COVID-19 Infection Taking ACEI/ARB
Identifieur interne : 000430 ( 2020/Analysis ); précédent : 000429; suivant : 000431Outcomes in Patients with COVID-19 Infection Taking ACEI/ARB
Auteurs : Juan Simon Rico-Mesa [États-Unis] ; Averi White [États-Unis] ; Allen S. Anderson [États-Unis]Source :
- Current Cardiology Reports [ 1523-3782 ] ; 2020.
Descripteurs français
- KwdFr :
- Antagonistes des récepteurs aux angiotensines (effets indésirables), Antagonistes des récepteurs aux angiotensines (usage thérapeutique), Comorbidité, Coronavirus (), Coronavirus (isolement et purification), Diabète de type 2 (), Diabète de type 2 (épidémiologie), Guides de bonnes pratiques cliniques comme sujet, Humains, Hypertension artérielle (), Hypertension artérielle (épidémiologie), Infections à coronavirus (traitement médicamenteux), 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), Pandémies, Peptidyl-Dipeptidase A (effets indésirables), Peptidyl-Dipeptidase A (usage thérapeutique), Pneumocytes (métabolisme), Pneumopathie virale (traitement médicamenteux), Pneumopathie virale (épidémiologie).
- MESH :
- effets indésirables : Antagonistes des récepteurs aux angiotensines, Inhibiteurs de l'enzyme de conversion de l'angiotensine, Peptidyl-Dipeptidase A.
- isolement et purification : Coronavirus.
- métabolisme : Pneumocytes.
- traitement médicamenteux : Infections à coronavirus, Pneumopathie virale.
- usage thérapeutique : Antagonistes des récepteurs aux angiotensines, Inhibiteurs de l'enzyme de conversion de l'angiotensine, Peptidyl-Dipeptidase A.
- épidémiologie : Diabète de type 2, Hypertension artérielle, Infections à coronavirus, Pneumopathie virale.
- Comorbidité, Coronavirus, Diabète de type 2, Guides de bonnes pratiques cliniques comme sujet, Humains, Hypertension artérielle, Pandémies.
English descriptors
- KwdEn :
- Alveolar Epithelial Cells (metabolism), Angiotensin Receptor Antagonists (adverse effects), Angiotensin Receptor Antagonists (therapeutic use), Angiotensin-Converting Enzyme Inhibitors (adverse effects), Angiotensin-Converting Enzyme Inhibitors (therapeutic use), Betacoronavirus, Comorbidity, Coronavirus (drug effects), Coronavirus (isolation & purification), Coronavirus Infections (drug therapy), Coronavirus Infections (epidemiology), Diabetes Mellitus, Type 2 (complications), Diabetes Mellitus, Type 2 (epidemiology), Humans, Hypertension (complications), Hypertension (epidemiology), Pandemics, Peptidyl-Dipeptidase A (adverse effects), Peptidyl-Dipeptidase A (therapeutic use), Pneumonia, Viral (drug therapy), Pneumonia, Viral (epidemiology), Practice Guidelines as Topic.
- MESH :
- chemical , adverse effects : Angiotensin Receptor Antagonists, Angiotensin-Converting Enzyme Inhibitors, Peptidyl-Dipeptidase A.
- complications : Diabetes Mellitus, Type 2, Hypertension.
- drug effects : Coronavirus.
- drug therapy : Coronavirus Infections, Pneumonia, Viral.
- epidemiology : Coronavirus Infections, Diabetes Mellitus, Type 2, Hypertension, Pneumonia, Viral.
- isolation & purification : Coronavirus.
- metabolism : Alveolar Epithelial Cells.
- chemical , therapeutic use : Angiotensin Receptor Antagonists, Angiotensin-Converting Enzyme Inhibitors, Peptidyl-Dipeptidase A.
- Betacoronavirus, Comorbidity, Humans, Pandemics, Practice Guidelines as Topic.
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus responsible for the aggressive coronavirus disease (COVID-19) pandemic. Recently, investigators have stipulated that COVID-19 patients receiving angiotensin-converting-enzyme inhibitors (ACEI) may be subject to poorer outcomes. This editorial presents the available evidence to guide treatment practices during this pandemic.
Recent studies from Wuhan cohorts provide valuable information about COVID-19. A cohort with 52 critically ill patients revealed cardiac injury in 12% of patients. Worse outcomes appear to be more prevalent in patients with hypertension and diabetes mellitus (DM), possibly due to overexpression of angiotensin-converting enzyme 2 (ACE2) receptor in airway alveolar epithelial cells. Investigators suspect that SARS-CoV-2 uses the ACE2 receptor to enter the lungs in a mechanism similar to SARS-CoV. Several hypotheses have been proposed to date regarding the net effect of ACEI/ARB on COVID-19 infections. Positive effects include ACE2 receptor blockade, disabling viral entry into the heart and lungs, and an overall decrease in inflammation secondary to ACEI/ARB. Negative effects include a possible retrograde feedback mechanism, by which ACE2 receptors are upregulated.
Even though physiological models of SARS-CoV infection show a theoretical benefit of ACEI/ARB, these findings cannot be extrapolated to SARS-CoV-2 causing COVID-19. Major cardiology scientific associations, including ACC, HFSA, AHA, and ESC Hypertension Council, have rejected these correlation hypotheses. After an extensive literature review, we conclude that there is no significant evidence to support an association for now, but given the rapid evolvement of this pandemic, findings may change.
Url:
DOI: 10.1007/s11886-020-01291-4
PubMed: 32291526
PubMed Central: 7154066
Affiliations:
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PMC:7154066Le document en format XML
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artérielle</term><term>Pandémies</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Purpose of Review</title><p id="Par1">Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus responsible for the aggressive coronavirus disease (COVID-19) pandemic. Recently, investigators have stipulated that COVID-19 patients receiving angiotensin-converting-enzyme inhibitors (ACEI) may be subject to poorer outcomes. This editorial presents the available evidence to guide treatment practices during this pandemic.</p></sec><sec><title>Recent Findings</title><p id="Par2">Recent studies from Wuhan cohorts provide valuable information about COVID-19. A cohort with 52 critically ill patients revealed cardiac injury in 12% of patients. Worse outcomes appear to be more prevalent in patients with hypertension and diabetes mellitus (DM), possibly due to overexpression of angiotensin-converting enzyme 2 (ACE2) receptor in airway alveolar epithelial cells. Investigators suspect that SARS-CoV-2 uses the ACE2 receptor to enter the lungs in a mechanism similar to SARS-CoV. Several hypotheses have been proposed to date regarding the net effect of ACEI/ARB on COVID-19 infections. Positive effects include ACE2 receptor blockade, disabling viral entry into the heart and lungs, and an overall decrease in inflammation secondary to ACEI/ARB. Negative effects include a possible retrograde feedback mechanism, by which ACE2 receptors are upregulated.</p></sec><sec><title>Summary</title><p id="Par3">Even though physiological models of SARS-CoV infection show a theoretical benefit of ACEI/ARB, these findings cannot be extrapolated to SARS-CoV-2 causing COVID-19. Major cardiology scientific associations, including ACC, HFSA, AHA, and ESC Hypertension Council, have rejected these correlation hypotheses. After an extensive literature review, we conclude that there is no significant evidence to support an association for now, but given the rapid evolvement of this pandemic, findings may change.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Watkins, J" uniqKey="Watkins J">J Watkins</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Texas</li></region></list><tree><country name="États-Unis"><region name="Texas"><name sortKey="Rico Mesa, Juan Simon" sort="Rico Mesa, Juan Simon" uniqKey="Rico Mesa J" first="Juan Simon" last="Rico-Mesa">Juan Simon Rico-Mesa</name></region><name sortKey="Anderson, Allen S" sort="Anderson, Allen S" uniqKey="Anderson A" first="Allen S." last="Anderson">Allen S. Anderson</name><name sortKey="White, Averi" sort="White, Averi" uniqKey="White A" first="Averi" last="White">Averi White</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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