This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
Research Article
Qingyuan ZHAN
Center for Respiratory Diseases, China-Japan Friendship Hospital; Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital; National Clinical Research Center for Respiratory Diseases, Beijing, China
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Objectives: To evaluate the impact of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) on coronavirus disease 2019 (COVID-19) patients.
Methods: We included 229 patients with confirmed COVID-19 in a multicenter, retrospective cohort study. Propensity score matching at a ratio of 1:4 was introduced to eliminate the potential confounders. Patients were assigned to the ACEI/ARB group (n=40) or control group (n=160) according to whether they were current users of medication.
Results: Compared to the control group, patients in the ACEI/ARB group had lower levels of plasma IL-1β [(6.27±0.50) vs. (8.23±0.39) pg/ml, P=0.028], IL-8 [(35.74±4.00) vs. (45.88±2.06) pg/ml, P=0.037] and TNF-α [(8.79±0.40) vs. (10.91±0.21) pg/ml, P<0.01]. Patients with the current use of ACEIs/ARBs had a higher risk of shock (23% vs. 8%, P<0.01). Decreased lymphocyte counts [(0.85±0.45) vs. (1.02±0.52)*10^9/L, P=0.041] and elevated plasma levels of IL-10 [(7.39±0.51) vs. (6.18±0.16) pg/ml, P<0.01] were also important discoveries in the ACEI/ARB group. Patients in the ACEI/ARB group had a prolonged duration of viral shedding [(25±7) vs. (20±6) days, P=0.031] and increased length of hospitalization [(23±12) vs. (16±8) days, P<0.01]. These trends were similar in patients with hypertension.
Conclusions: For patients with excessive inflammatory responses and stable hemodynamics, ACEIs or ARBs might be tried to relieve the inflammatory storm, but the antiviral treatment should be enforced and the hemodynamics should be monitored closely; for patients with low levels of proinflammatory factors or instability hemodynamics, the agents might not be used to avoid a delay in viral clearance or increase the risk of shock.
Keywords
ACE inhibitor, ARB, inflammatory response, viral clearance
Figure 1
Figure 2
Loading...
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 08 May, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Learn more about our company.
A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research Article
Qingyuan ZHAN
Center for Respiratory Diseases, China-Japan Friendship Hospital; Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital; National Clinical Research Center for Respiratory Diseases, Beijing, China
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 08 May, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Objectives: To evaluate the impact of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) on coronavirus disease 2019 (COVID-19) patients.
Methods: We included 229 patients with confirmed COVID-19 in a multicenter, retrospective cohort study. Propensity score matching at a ratio of 1:4 was introduced to eliminate the potential confounders. Patients were assigned to the ACEI/ARB group (n=40) or control group (n=160) according to whether they were current users of medication.
Results: Compared to the control group, patients in the ACEI/ARB group had lower levels of plasma IL-1β [(6.27±0.50) vs. (8.23±0.39) pg/ml, P=0.028], IL-8 [(35.74±4.00) vs. (45.88±2.06) pg/ml, P=0.037] and TNF-α [(8.79±0.40) vs. (10.91±0.21) pg/ml, P<0.01]. Patients with the current use of ACEIs/ARBs had a higher risk of shock (23% vs. 8%, P<0.01). Decreased lymphocyte counts [(0.85±0.45) vs. (1.02±0.52)*10^9/L, P=0.041] and elevated plasma levels of IL-10 [(7.39±0.51) vs. (6.18±0.16) pg/ml, P<0.01] were also important discoveries in the ACEI/ARB group. Patients in the ACEI/ARB group had a prolonged duration of viral shedding [(25±7) vs. (20±6) days, P=0.031] and increased length of hospitalization [(23±12) vs. (16±8) days, P<0.01]. These trends were similar in patients with hypertension.
Conclusions: For patients with excessive inflammatory responses and stable hemodynamics, ACEIs or ARBs might be tried to relieve the inflammatory storm, but the antiviral treatment should be enforced and the hemodynamics should be monitored closely; for patients with low levels of proinflammatory factors or instability hemodynamics, the agents might not be used to avoid a delay in viral clearance or increase the risk of shock.
Figure 1
Figure 2
Loading...