Renin–Angiotensin–Aldosterone System Inhibitors and Risk of Covid-19

@article{Reynolds2020ReninAngiotensinAldosteroneSI,
  title={Renin–Angiotensin–Aldosterone System Inhibitors and Risk of Covid-19},
  author={Harmony R. Reynolds and Samrachana Adhikari and Claudia P. Pulgarin and Andrea B. Troxel and Eduardo Iturrate and Stephen B. Johnson and Anais Hausvater and Jonathan D. Newman and Jeffrey S. Berger and Sripal Bangalore and Stuart D. Katz and Glenn I. Fishman and Dennis Kunichoff and Ying Chen and Gbenga Ogedegbe and Judith S. Hochman},
  journal={The New England Journal of Medicine},
  year={2020}
}
Abstract Background There is concern about the potential of an increased risk related to medications that act on the renin–angiotensin–aldosterone system in patients exposed to coronavirus disease 2019 (Covid-19), because the viral receptor is angiotensin-converting enzyme 2 (ACE2). Methods We assessed the relation between previous treatment with ACE inhibitors, angiotensin-receptor blockers, beta-blockers, calcium-channel blockers, or thiazide diuretics and the likelihood of a positive or… Expand
Hypertension, renin–angiotensin–aldosterone system inhibition, and COVID-19
TLDR
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TLDR
Although further research on the influence of blood-pressure-lowering drugs, including those not targeting the renin-angiotensin system, is warranted, there are presently no compelling clinical data showing that ACEIs and ARBs increase the likelihood of contracting COVID-19 or worsen the outcome of SARS-CoV‑2 infections. Expand
Renin-angiotensin system inhibition in COVID-19 patients
TLDR
Although further research on the influence of blood-pressure-lowering drugs, including those not targeting the renin-angiotensin system, is warranted, there are presently no compelling clinical data showing that ACEIs and ARBs increase the likelihood of contracting COVID-19 or worsen the outcome of SARS-CoV‑2 infections. Expand
Renin-Angiotensin System Blockers and the Risk of COVID-19-Related Mortality in Patients with Kidney Failure.
TLDR
There was no significant association between kidney transplant and dialysis patients with COVID-19 use or ACEi/ARB discontinuation with mortality, and results were obtained across subgroups when ACEi and ARB were studied separately and when other outcomes for CO VID-19 severity were studied e.g., hospital admission, intensive care unit admission or need for ventilator support. Expand
Use of inhibitors of the renin angiotensin system and COVID-19 prognosis: a systematic review and meta-analysis
TLDR
It is suggested that the use of ACEI/ARB does not worsen the prognosis, and could even be protective in hypertensive subjects, and patients should continue these drugs during their COVID-19 illness. Expand
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References

SHOWING 1-10 OF 23 REFERENCES
Renin-angiotensin system inhibitors improve the clinical outcomes of COVID-19 patients with hypertension
TLDR
Evidence supports the benefit of using ACEIs or ARBs to potentially contribute to the improvement of clinical outcomes of COVID-19 patients with hypertension. Expand
Anti-hypertensive Angiotensin II receptor blockers associated to mitigation of disease severity in elderly COVID-19 patients
  • Yingxia Liu, Fengming Huang, +15 authors Chengyu Jiang
  • Medicine
  • medRxiv
  • 2020
TLDR
Elderly COVID-19 patients with hypertension comorbidity who are taking ARB anti-hypertension drugs may be less likely to develop severe lung disease compared to patients who take no anti- hypertension drugs. Expand
Effect of Angiotensin-Converting Enzyme Inhibition and Angiotensin II Receptor Blockers on Cardiac Angiotensin-Converting Enzyme 2
TLDR
Although the predominant effect of ACE inhibition may result from the combined effect of reduced Ang II formation and Ang-(1–7) metabolism, the antihypertensive action of AT1 antagonists may in part be due to increased Ang II metabolism by ACE2. Expand
Combined Antihypertensive Therapies That Increase Expression of Cardioprotective Biomarkers Associated With the Renin–Angiotensin and Kallikrein–Kinin Systems
TLDR
A decrease in the expression of ACE and AT1 suggests a reduction in theexpression of Ang II that could be related to a lower response to this vasoconstrictor, and an increase in the Expression of B1 would improve vasodilation, which would a beneficial effect of combined therapies for hypertension. Expand
Renin–Angiotensin–Aldosterone System Inhibitors in Patients with Covid-19
TLDR
RAAS Inhibitors in Patients with Covid-19 show low levels of renin–angiotensin-converting enzyme 2 levels and activity in humans, but the effects are still uncertain. Expand
β-adrenergic receptor blockade as a therapeutic approach for suppressing the renin-angiotensin-aldosterone system in normotensive and hypertensive subjects
TLDR
It is shown that beta-blockers suppress plasma angiotensin II levels, in parallel with the marked reductions in PRA and urinary aldosterone levels in normotensive and hypertensive subjects, which has important implications for the treatment of cardiovascular disease. Expand
Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection?
TLDR
It is suggested that patients with cardiac diseases, hypertension, or diabetes, who are treated with ACE2increasing drugs, are at higher risk for severe COVID-19 infection and, therefore, should be monitored for ACE2-modulating medications, such as ACE inhibitors or ARBs. Expand
Beta-adrenergic receptor blockade as a therapeutic approach for suppressing the renin-angiotensin-aldosterone system in normotensive and hypertensive subjects.
TLDR
It is shown that beta-blockers suppress plasma angiotensin II levels, in parallel with the marked reductions in PRA and urinary aldosterone levels in normotensive and hypertensive subjects, which has important implications for the treatment of cardiovascular disease. Expand
Elevated plasma angiotensin converting enzyme 2 activity is an independent predictor of major adverse cardiac events in patients with obstructive coronary artery disease
TLDR
Plasma ACE2 activity independently increased the hazard of adverse long-term cardiovascular outcomes in patients with obstructive CAD. Expand
Angiotensin converting enzyme 2 activity and human atrial fibrillation: increased plasma angiotensin converting enzyme 2 activity is associated with atrial fibrillation and more advanced left atrial structural remodelling
TLDR
Both AF and vascular disease predict elevated plasmaACE2 activity, and elevated plasma ACE2 is significantly associated with more advanced LA structural remodelling. Expand
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