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Titel:

Angiotensin II receptor blocker intake associates with reduced markers of inflammatory activation and decreased mortality in patients with cardiovascular comorbidities and COVID-19 disease.

Dokumenttyp:
Article; Journal Article; Research Support, Non-U.S. Gov't
Autor(en):
Cremer, Sebastian; Pilgram, Lisa; Berkowitsch, Alexander; Stecher, Melanie; Rieg, Siegbert; Shumliakivska, Mariana; Bojkova, Denisa; Wagner, Julian Uwe Gabriel; Aslan, Galip Servet; Spinner, Christoph; Luxán, Guillermo; Hanses, Frank; Dolff, Sebastian; Piepel, Christiane; Ruppert, Clemens; Guenther, Andreas; Rüthrich, Maria Madeleine; Vehreschild, Jörg Janne; Wille, Kai; Haselberger, Martina; Heuzeroth, Hanno; Hansen, Arne; Eschenhagen, Thomas; Cinatl, Jindrich; Ciesek, Sandra; Dimmeler, Stefani...     »
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.
Zeitschriftentitel:
PLoS ONE
Jahr:
2021
Band / Volume:
16
Heft / Issue:
10
Volltext / DOI:
doi:10.1371/journal.pone.0258684
PubMed:
http://view.ncbi.nlm.nih.gov/pubmed/34673795
Print-ISSN:
1932-6203
TUM Einrichtung:
1036; II. Medizinische Klinik und Poliklinik (Gastroenterologie)
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