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Angiotensin II receptor blocker intake associates with reduced markers of inflammatory activation and decreased mortality in patients with cardiovascular comorbidities and COVID-19 disease.
- Source :
-
PloS one [PLoS One] 2021 Oct 21; Vol. 16 (10), pp. e0258684. Date of Electronic Publication: 2021 Oct 21 (Print Publication: 2021). - Publication Year :
- 2021
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Abstract
- Aims: Patients with cardiovascular comorbidities have a significantly increased risk for a critical course of COVID-19. As the SARS-CoV2 virus enters cells via the angiotensin-converting enzyme receptor II (ACE2), drugs which interact with the renin angiotensin aldosterone system (RAAS) were suspected to influence disease severity.<br />Methods and Results: We analyzed 1946 consecutive patients with cardiovascular comorbidities or hypertension enrolled in one of the largest European COVID-19 registries, the Lean European Open Survey on SARS-CoV-2 (LEOSS) registry. Here, we show that angiotensin II receptor blocker intake is associated with decreased mortality in patients with COVID-19 [OR 0.75 (95% CI 0,59-0.96; p = 0.013)]. This effect was mainly driven by patients, who presented in an early phase of COVID-19 at baseline [OR 0,64 (95% CI 0,43-0,96; p = 0.029)]. Kaplan-Meier analysis revealed a significantly lower incidence of death in patients on an angiotensin receptor blocker (ARB) (n = 33/318;10,4%) compared to patients using an angiotensin-converting enzyme inhibitor (ACEi) (n = 60/348;17,2%) or patients who received neither an ACE-inhibitor nor an ARB at baseline in the uncomplicated phase (n = 90/466; 19,3%; p<0.034). Patients taking an ARB were significantly less frequently reaching the mortality predicting threshold for leukocytes (p<0.001), neutrophils (p = 0.002) and the inflammatory markers CRP (p = 0.021), procalcitonin (p = 0.001) and IL-6 (p = 0.049). ACE2 expression levels in human lung samples were not altered in patients taking RAAS modulators.<br />Conclusion: These data suggest a beneficial effect of ARBs on disease severity in patients with cardiovascular comorbidities and COVID-19, which is linked to dampened systemic inflammatory activity.<br />Competing Interests: The authors have declared that no competing interests exist.
- Subjects :
- Adult
Aged
Aged, 80 and over
Angiotensin-Converting Enzyme Inhibitors administration & dosage
Biomarkers blood
Comorbidity
Disease-Free Survival
Female
Humans
Inflammation blood
Inflammation drug therapy
Inflammation mortality
Male
Middle Aged
Severity of Illness Index
Survival Rate
Angiotensin Receptor Antagonists administration & dosage
COVID-19 blood
COVID-19 mortality
Hypertension blood
Hypertension drug therapy
Hypertension mortality
Registries
SARS-CoV-2 metabolism
COVID-19 Drug Treatment
Subjects
Details
- Language :
- English
- ISSN :
- 1932-6203
- Volume :
- 16
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- PloS one
- Publication Type :
- Academic Journal
- Accession number :
- 34673795
- Full Text :
- https://doi.org/10.1371/journal.pone.0258684