Cremer, Sebastian and Pilgram, Lisa and Berkowitsch, Alexander and Stecher, Melanie and Rieg, Siegbert and Shumliakivska, Mariana and Bojkova, Denisa and Wagner, Julian Uwe Gabriel and Aslan, Galip Servet and Spinner, Christoph and Luxan, Guillermo and Hanses, Frank and Dolff, Sebastian and Piepel, Christiane and Ruppert, Clemens and Guenther, Andreas and Ruthrich, Maria Madeleine and Vehreschild, Jorg Janne and Wille, Kai and Haselberger, Martina and Heuzeroth, Hanno and Hansen, Arne and Eschenhagen, Thomas and Cinatl, Jindrich and Ciesek, Sandra and Dimmeler, Stefanie and Borgmann, Stefan and Zeiher, Andreas (2021) Angiotensin II receptor blocker intake associates with reduced markers of inflammatory activation and decreased mortality in patients with cardiovascular comorbidities and COVID-19 disease. PLOS ONE, 16 (10): e0258684. ISSN 1932-6203,
Full text not available from this repository. (Request a copy)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. 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. 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.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ACE2; EXPRESSION; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Abteilung für Krankenhaushygiene und Infektiologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 27 Sep 2022 12:28 |
| Last Modified: | 27 Sep 2022 12:28 |
| URI: | https://pred.uni-regensburg.de/id/eprint/48077 |
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