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Treatment with ACE-inhibitors is associated with less severe disease with SARS-Covid-19 infection in a multi-site UK acute Hospital Trust
Daniel Bean.
Zeljko Kraljevic.
Thomas Searle.
Rebecca Bendayan.
Andrew Pickles.
Amos Folarin.
Lukasz Roguski.
Kawsar Noor.
Anthony Shek.
Rosita Zakeri.
Ajay Shah.
James Teo.
Richard JB Dobson.
Acceso Abierto
Atribución-NoComercial-SinDerivadas
10.1101/2020.04.07.20056788
Abstract: Background: The SARS-Cov2 virus binds to the ACE2 receptor for cell entry. It has been suggested that ACE-inhibitors, which are commonly used in patients with hypertension or diabetes and which raise ACE2 levels, may increase the risk of severe COVID-19 infection. Methods: We evaluated this hypothesis in an early cohort of 205 acute inpatients with COVID-19 at King's College Hospital and Princess Royal University Hospital, London, UK with the primary endpoint being death or transfer to a critical care unit for organ support within 7-days of symptom onset. Findings: 53 patients out of 205 patients reached the primary endpoint. Contrary to the hypothesis, treatment with ACE-inhibitors was associated with a reduced risk of rapidly deteriorating severe disease. There was a lower rate of death or transfer to a critical care unit within 7 days in patients on an ACE-inhibitor OR 0.29 (CI 0.10-0.75, p<0.01), adjusting for age, gender, comorbidities (hypertension, diabetes mellitus, ischaemic heart disease and heart failure). Interpretation: Although a small sample size, we do not see evidence for ACE-inhibitors increasing the short-term severity of COVID-19 disease and patients on treatment with ACE-inhibitors should continue these drugs during their COVID-19 illness. A potential beneficial effect needs to be explored as more data becomes available.
www.medrxiv.org
2020
Artículo
https://www.medrxiv.org/content/10.1101/2020.04.07.20056788v1.full.pdf
Inglés
VIRUS RESPIRATORIOS
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