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Dennis OConnor

The Coronavirus Conundrum: ACE2 and Hypertension Edition - NephJC - 0 views

www.nephjc.com/covidace2

covid ARB_ACEi hypertension

shared by Dennis OConnor on 17 Mar 20 - No Cached
  • Hypertension and COVID19
  • Are patients with hypertension more likely to get COVID19?For this, we need a well-designed cohort study with incidence rates of COVID19 in patients with hypertension (HT) and those without HT, in which exposure history is able to be carefully accounted for.
  • Amongst the patients with COVID19, it seems the prevalence of prior h/o HT is higher in those who develop severe disease than those who do not.
  • ...3 more annotations...
  • Hypertension does seem to be a common comorbidity, even more so than diabetes - but these are all data from one country, so one should be careful before generalization.
  • Why might there be a link between high blood pressure and COVID19?As you can read so far, we are not convinced the data show a strong, robust link. However, the virus uses the renin-angiotensin system - hence all the speculation. Read about the science behind the speculation below.
  • Can ARB/ACEi use (and potentially increased ACE2) actually be beneficial in coronavirus and other viral pneumonias?This is an interesting question and has been looked at in both animal model and human studies (retrospective). This study looked at patients (humans) with viral pneumonia and demonstrated an association with improved outcomes in patients with continued ACEi use during viral pneumonia. However, you could argue that patients with viral pneumonia who had continued use of ACEi while hospitalized were not “as sick” as patients in which it was discontinued. 
  • Dennis OConnor on 17 Mar 20
     
    Recommended by DeAunne Denmark, MD, PhD: "... this excellent international society and expert consensus site regarding anti-hypertensives and ACE2, the protein used by both SARS for host cell.
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