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Possible Benefit of Angiotensin II Receptor Blockers in COVID-19 Patients: A Case Series.

Abstract

Introduction

Dysfunction in the renin-angiotensin-aldosterone system (RAAS) has been observed in patients with coronavirus disease 2019 (COVID-19). It is presumed that the effect of reducing interleukin-6 (IL-6) levels by angiotensin II receptor blockers (ARBs) by RAAS modulation. We investigated changes in angiotensin II and IL-6 levels in four COVID-19 patients treated with ARBs. Case Presentation. Cases 1 and 2 were who had not received ARBs before and were newly administered ARBs. Case 3 restarted ARBs after discontinuation for 7 days, and case 4 received an increased dose of ARBs. The mean in angiotensin II levels (607.5 pg/mL, range: 488-850 pg/mL, reference range < 100 pg/mL), C-reactive protein (CRP) (10.58 mg/dL, range 4.45-18.05 mg/dL), and IL-6 (55.78 pg/mL, range: 12.86-144.82 pg/mL, reference range < 7 pg/mL) was observed at the admission in all patients. Upon clinical improvement, the mean decrease in CRP (1.02 mg/dL, range 0.06-3.78 mg/dL) and IL-6 (5.63 pg/mL, range 0.17-20.87 pg/mL) was observed in all patients. Conversely, angiotensin II levels gradually increased.

Conclusion

This report supports the potential benefit of ARBs to improve the clinical outcomes of COVID-19 patients by controlling RAAS dysfunction.

Authors+Show Affiliations

Division of Infectious Disease, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea. Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.Division of Infectious Disease, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea. Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

34285712

Citation

Lee, Su Jin, et al. "Possible Benefit of Angiotensin II Receptor Blockers in COVID-19 Patients: a Case Series." Journal of the Renin-angiotensin-aldosterone System : JRAAS, vol. 2021, 2021, p. 9951540.
Lee SJ, Kim T, Cho WH, et al. Possible Benefit of Angiotensin II Receptor Blockers in COVID-19 Patients: A Case Series. J Renin Angiotensin Aldosterone Syst. 2021;2021:9951540.
Lee, S. J., Kim, T., Cho, W. H., Jeon, D., & Lim, S. (2021). Possible Benefit of Angiotensin II Receptor Blockers in COVID-19 Patients: A Case Series. Journal of the Renin-angiotensin-aldosterone System : JRAAS, 2021, 9951540. https://doi.org/10.1155/2021/9951540
Lee SJ, et al. Possible Benefit of Angiotensin II Receptor Blockers in COVID-19 Patients: a Case Series. J Renin Angiotensin Aldosterone Syst. 2021;2021:9951540. PubMed PMID: 34285712.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Possible Benefit of Angiotensin II Receptor Blockers in COVID-19 Patients: A Case Series. AU - Lee,Su Jin, AU - Kim,Taehwa, AU - Cho,Woo Hyun, AU - Jeon,Doosoo, AU - Lim,Seungjin, Y1 - 2021/05/13/ PY - 2021/02/26/received PY - 2021/04/22/accepted PY - 2021/7/21/entrez PY - 2021/7/22/pubmed PY - 2021/7/29/medline SP - 9951540 EP - 9951540 JF - Journal of the renin-angiotensin-aldosterone system : JRAAS JO - J Renin Angiotensin Aldosterone Syst VL - 2021 N2 - Introduction: Dysfunction in the renin-angiotensin-aldosterone system (RAAS) has been observed in patients with coronavirus disease 2019 (COVID-19). It is presumed that the effect of reducing interleukin-6 (IL-6) levels by angiotensin II receptor blockers (ARBs) by RAAS modulation. We investigated changes in angiotensin II and IL-6 levels in four COVID-19 patients treated with ARBs. Case Presentation. Cases 1 and 2 were who had not received ARBs before and were newly administered ARBs. Case 3 restarted ARBs after discontinuation for 7 days, and case 4 received an increased dose of ARBs. The mean in angiotensin II levels (607.5 pg/mL, range: 488-850 pg/mL, reference range < 100 pg/mL), C-reactive protein (CRP) (10.58 mg/dL, range 4.45-18.05 mg/dL), and IL-6 (55.78 pg/mL, range: 12.86-144.82 pg/mL, reference range < 7 pg/mL) was observed at the admission in all patients. Upon clinical improvement, the mean decrease in CRP (1.02 mg/dL, range 0.06-3.78 mg/dL) and IL-6 (5.63 pg/mL, range 0.17-20.87 pg/mL) was observed in all patients. Conversely, angiotensin II levels gradually increased. Conclusion: This report supports the potential benefit of ARBs to improve the clinical outcomes of COVID-19 patients by controlling RAAS dysfunction. SN - 1752-8976 UR - https://www.unboundmedicine.com/medline/citation/34285712/Possible_Benefit_of_Angiotensin_II_Receptor_Blockers_in_COVID-19_Patients:_A_Case_Series. L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/34285712/ DB - PRIME DP - Unbound Medicine ER -