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[Effects of angiotensin converting enzyme inhibitor/angiotensin receptor blocker on clinical characteristics of coronavirus disease 2019 patients with hypertension].
Zhonghua Nei Ke Za Zhi. 2020 Sep 01; 59(9):689-694.ZN

Abstract

Objective:

To analyze the effects of angiotensin converting enzyme inhibitor/angiotensin receptor blocker (ACEI/ARB) on coronavirus disease 2019 (COVID-19) patients with hypertension, and to provide an evidence for selecting antihypertensive drugs in those patients.

Methods:

Clinical data were retrospectively analyzed in 58 COVID-19 patients with hypertension admitted to Shanghai Public Health Clinical Center from January 20 to February 22, 2020, including epidemiological history, clinical manifestations, laboratory findings, chest CT and outcome. Patients were divided into ACEI/ARB group and non-ACEI/ARB group.

Results:

Twenty-six patients were in ACEI/ARB group and the other 32 patients in non-ACEI/ARB group, with median age 64.0 (49.5, 72.0) years and 64.0 (57.0, 68.8) years respectively. The median time to onset was 5(3, 8) days in ACEI/ARB group and 4 (3, 7) days in non-ACEI/ARB group, the proportion of patients with severe or critical illness was 19.2% and 15.6% respectively. The main clinical symptoms in two groups were fever (80.8% vs. 84.4%) and cough (23.1% vs. 31.3%). The following parameters were comparable including lymphocyte counts, C-reactive protein, lactate dehydrogenase, D-dimer, bilateral involvement in chest CT (76.9% vs. 71.9%), worsening of COVID-19 (15.4% vs. 9.4%), favorable outcome (92.3% vs. 96.9%) between ACEI/ARB group and non-ACEI/ARB group respectively (all P>0.05). However, compared with non-ACEI/ARB group, serum creatinine [80.49 (68.72, 95.30) μmol/L vs. 71.29 (50.98, 76.98) μmol/L, P=0.007] was higher significantly in ACEI/ARB group.

Conclusions:

ACEI/ARB drugs have no significant effects on baseline clinical parameters (serum creatine and myoglobin excluded) , outcome, and prognosis of COVID-19 patients with hypertension. Antihypertensive drugs are not suggested to adjust in those patients, but the potential impairment of renal function as elevation of serum creatinine should be paid attention in patients administrating ACEI/ARB drugs.

Authors+Show Affiliations

Department of Tuberculosis, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.Department of Tuberculosis, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.Deparment of Infectious Disease, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.Department of Severe Hepatology, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.Department of Severe Hepatology, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.Department of Hepatobiliary Disease, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.Department of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.Department of Tuberculosis, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.Department of Tuberculosis, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.Department of Tuberculosis, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.Department of Tuberculosis, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.Department of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.

Pub Type(s)

Journal Article

Language

chi

PubMed ID

32838499

Citation

Huang, W, et al. "[Effects of Angiotensin Converting Enzyme Inhibitor/angiotensin Receptor Blocker On Clinical Characteristics of Coronavirus Disease 2019 Patients With Hypertension]." Zhonghua Nei Ke Za Zhi, vol. 59, no. 9, 2020, pp. 689-694.
Huang W, Li T, Ling Y, et al. [Effects of angiotensin converting enzyme inhibitor/angiotensin receptor blocker on clinical characteristics of coronavirus disease 2019 patients with hypertension]. Zhonghua Nei Ke Za Zhi. 2020;59(9):689-694.
Huang, W., Li, T., Ling, Y., Qian, Z. P., Zhang, Y. Y., Huang, D., Xu, S. B., Liu, X. H., Xia, L., Yang, Y., Lu, S. H., & Lu, H. Z. (2020). [Effects of angiotensin converting enzyme inhibitor/angiotensin receptor blocker on clinical characteristics of coronavirus disease 2019 patients with hypertension]. Zhonghua Nei Ke Za Zhi, 59(9), 689-694. https://doi.org/10.3760/cma.j.cn112138-20200229-00155
Huang W, et al. [Effects of Angiotensin Converting Enzyme Inhibitor/angiotensin Receptor Blocker On Clinical Characteristics of Coronavirus Disease 2019 Patients With Hypertension]. Zhonghua Nei Ke Za Zhi. 2020 Sep 1;59(9):689-694. PubMed PMID: 32838499.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Effects of angiotensin converting enzyme inhibitor/angiotensin receptor blocker on clinical characteristics of coronavirus disease 2019 patients with hypertension]. AU - Huang,W, AU - Li,T, AU - Ling,Y, AU - Qian,Z P, AU - Zhang,Y Y, AU - Huang,D, AU - Xu,S B, AU - Liu,X H, AU - Xia,L, AU - Yang,Y, AU - Lu,S H, AU - Lu,H Z, PY - 2020/8/26/entrez PY - 2020/8/26/pubmed PY - 2020/8/28/medline KW - Angiotensin converting enzyme inhibitor KW - Angiotensin Ⅱ receptor antagonist KW - Clinical characteristics KW - Coronavirus disease 2019 SP - 689 EP - 694 JF - Zhonghua nei ke za zhi JO - Zhonghua Nei Ke Za Zhi VL - 59 IS - 9 N2 - Objective: To analyze the effects of angiotensin converting enzyme inhibitor/angiotensin receptor blocker (ACEI/ARB) on coronavirus disease 2019 (COVID-19) patients with hypertension, and to provide an evidence for selecting antihypertensive drugs in those patients. Methods: Clinical data were retrospectively analyzed in 58 COVID-19 patients with hypertension admitted to Shanghai Public Health Clinical Center from January 20 to February 22, 2020, including epidemiological history, clinical manifestations, laboratory findings, chest CT and outcome. Patients were divided into ACEI/ARB group and non-ACEI/ARB group. Results: Twenty-six patients were in ACEI/ARB group and the other 32 patients in non-ACEI/ARB group, with median age 64.0 (49.5, 72.0) years and 64.0 (57.0, 68.8) years respectively. The median time to onset was 5(3, 8) days in ACEI/ARB group and 4 (3, 7) days in non-ACEI/ARB group, the proportion of patients with severe or critical illness was 19.2% and 15.6% respectively. The main clinical symptoms in two groups were fever (80.8% vs. 84.4%) and cough (23.1% vs. 31.3%). The following parameters were comparable including lymphocyte counts, C-reactive protein, lactate dehydrogenase, D-dimer, bilateral involvement in chest CT (76.9% vs. 71.9%), worsening of COVID-19 (15.4% vs. 9.4%), favorable outcome (92.3% vs. 96.9%) between ACEI/ARB group and non-ACEI/ARB group respectively (all P>0.05). However, compared with non-ACEI/ARB group, serum creatinine [80.49 (68.72, 95.30) μmol/L vs. 71.29 (50.98, 76.98) μmol/L, P=0.007] was higher significantly in ACEI/ARB group. Conclusions: ACEI/ARB drugs have no significant effects on baseline clinical parameters (serum creatine and myoglobin excluded) , outcome, and prognosis of COVID-19 patients with hypertension. Antihypertensive drugs are not suggested to adjust in those patients, but the potential impairment of renal function as elevation of serum creatinine should be paid attention in patients administrating ACEI/ARB drugs. SN - 0578-1426 UR - https://www.unboundmedicine.com/medline/citation/32838499/[Effects_of_angiotensin_converting_enzyme_inhibitor/angiotensin_receptor_blocker_on_clinical_characteristics_of_coronavirus_disease_2019_patients_with_hypertension]_ L2 - https://medlineplus.gov/highbloodpressure.html DB - PRIME DP - Unbound Medicine ER -