Updates on coronavirus (COVID-19) and kidney

2020 ◽  
Vol 9 (4) ◽  
pp. e34-e34 ◽  
Author(s):  
Seyed Zanyar Athari ◽  
Daryoush Mohajeri ◽  
Mir Alireza Nourazar ◽  
Yousef Doustar
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Angiotensin Converting Enzyme ◽  
Enzyme Inhibitor ◽  
Case Reports ◽  
Angiotensin Receptor Blockers ◽  
Kidney Injury ◽  
Current Treatment ◽  
High Risk Group ◽  
Converting Enzyme ◽  
Renal Disorder

The severe acute respiratory syndrome (SARS) is an infectious disease developed in Wuhan, China, at first. It involves the respiratory system and other organs like kidney, gastrointestinal tract and nervous system as well. The recent reports indicated that renal disorder is prevalent in coronavirus patients. The aim of this study was to provide a review of nephropathy caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) and its mechanisms. The Web of Science, Scopus, and PubMed databases were systematically searched. Articles reporting nephropathy, coronavirus disease (COVID-19), coronavirus and the renal injury were included for assessment. Study designs, contrast agents, case reports and results were assessed. Of the assessed studies, suggested mechanisms include sepsis which caused cytokine storm syndrome or perhaps direct cellular injury due to the virus. In patients who were studied, albuminuria, proteinuria, and hematuria as well as an elevation in blood urea nitrogen and serum creatinine were observed. Additionally CT scan of the kidneys showed a decrease in tissue density suggestive of inflammation and interstitial edema. On the other hand, dialysis patients are a high-risk group than the general population. The current treatment for COVID-19 in acute kidney injury includes supportive management or kidney replacement therapy. All patients need to be quarantined. An N95 fit-tested mask and protective clothing and proper equipment are necessary. Some drugs can be effective to inhibit the outcome of this infection such as lopinavir/ritonavir, remdesvir, Chloroquine phosphate, convalescent plasma, tocilizumab, ACEi/ ARBs (angiotensin-converting enzyme inhibitor/angiotensin receptor blockers), and hrsACE2 (human recombinant soluble angiotensin-converting-enzyme 2).

Impact of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers on Renal Function in Type 1 Cardiorenal Syndrome

2021 ◽  
pp. 107424842110226
Author(s):  
Daniel T. Ilges ◽  
Morgan L. Dermody ◽  
Caitlyn Blankenship ◽  
Valerie Mansfield ◽  
Joseph S. Van Tuyl
Keyword(s):  
Renal Function ◽  
Angiotensin Converting Enzyme ◽  
Enzyme Inhibitor ◽  
Angiotensin Receptor Blockers ◽  
Kidney Injury ◽  
Cardiorenal Syndrome ◽  
Converting Enzyme ◽  
Angiotensin Receptor ◽  
Converting Enzyme Inhibitors

Introduction: Angiotensin-converting enzyme inhibitor (ACE-I) and angiotensin receptor blocker (ARB) discontinuation during acute heart failure (AHF) is associated with increased mortality following hospitalization. Although the etiology of acute kidney injury (AKI) in type 1 cardiorenal syndrome (CRS) has been linked to renal venous congestion, ACE-I/ARB withdrawal (AW) theoretically promotes renal function recovery. ACE-I/ARBs are dose-reduced or withheld in approximately half of patients with CRS, but the subsequent impact on renal function remains largely uninvestigated. This study compared AW to ACE-I/ARB continuation (AC) during CRS. Methods: This was a retrospective, single-center chart review. Patients aged 18-89 years admitted from April 2018 to August 2019 with AHF and AKI were identified using discharge ICD-10 codes. All patients were treated with an ACE-I/ARB before admission. Key exclusion criteria included shock, pregnancy, and end-stage renal disease. The primary endpoint was change in serum creatinine (SCr) from admission through 72 hours. Data were analyzed utilizing chi-square and Mann-Whitney U tests with SPSS software. Results: A total of 111 admissions were included. AW occurred in 68 patients upon admission. AW patients presented with a higher blood urea nitrogen ( P = 0.034), higher SCr ( P = 0.021), and lower ejection fraction ( P = 0.04). Median SCr change from admission to 72 hours did not differ between groups (AW −0.1 mg/dL vs AC 0.0 mg/dL, P = 0.05). There was no difference in SCr reduction ≥0.3 mg/dL at 72 hours, 30-day readmissions, or ACE-I/ARB prescription at discharge. Conclusions: In patients with type 1 CRS, AW was not associated with improved renal function at 72 hours. A larger sample size is necessary to confirm these results.

scholarly journals Pengaruh penggunaan angiotensin converting enzyme inhibitor (ACEI) dan angiotensin receptor blocker (ARB) pada pasien coronavirus disease 2019 (covid-19) dengan hipertensi

e-CliniC ◽  
2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Briando Linelejan ◽  
Octavianus Umboh ◽  
Frans E. N. Wantania
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Literature Review ◽  
Angiotensin Converting Enzyme ◽  
Angiotensin Converting Enzyme Inhibitor ◽  
Enzyme Inhibitor ◽  
Angiotensin Receptor Blockers ◽  
Converting Enzyme ◽  
Angiotensin Receptor ◽  
Converting Enzyme Inhibitor ◽  
Receptor Blockers

Abstract: Hypertension is considered as one of the highest death-caused disease worldwide. Coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) most frequently occurred in elderly and those who had comorbid diseases, one of them is hypertension. The first line drugs that are usually used in hypertension are angiotensin converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs). It is assumed that these drugs coud influence the progress of COVID-19 due to the similiar target receptor. This study was aimed to evaluate the influence of ACEIs and ARBs to patients with COVID-19 and hypertension. This was a literature review study using literatures published in medical journal databases such as PubMed and ClinicalKey. The results obtained 10 literatures that fulfilled the inclusion and exclusion criteria. These ten literatures stated that there was no influence of using ACEIs and ARBs in COVID-19 patients. In conclusion, ACEIs and ARBs do not influence the mortality or progresivity of COVID-19 disease and are suggested to be consumed continually.Keywords: ACEIs, ARBs, COVID-19, hypertension, hypertension in COVID-19 Abstrak: Hipertensi merupakan salah satu penyebab kematian tertinggi di dunia. Pandemik coronavirus disease 2019 (COVID-19) dengan severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sebagai etiologinya kebanyakan terjadi pada usia tua serta yang memiliki penyakit komorbid, salah satu yang tersering ialah hipertensi. Obat lini pertama yang biasa digunakan untuk hipertensi yaitu angiotensin converting enzyme inhibitor (ACEI) dan angiotensin receptor blockers (ARB) dikatakan dapat memengaruhi perkembangan penyakit COVID-19 karena memiliki reseptor atau tempat kerja yang mirip. Penelitian ini bertujuan untuk mengevaluasi pengaruh penggunaan ACEI dan ARB pada pasien COVID-19 dengan hipertensi. Jenis penelitian ialah literature review dengan menggunakan literatur-literatur yang dipublikasi dalam database jurnal kedokteran PubMed dan ClinicalKey sesuai dengan kriteria inklusi dan eksklusi penelitian. Hasil penelitian mendapatkan 10 literatur; kesemuanya menyatakan bahwa tidak terdapat pengaruh penggunaan ACEI dan ARB terhadap pasien COVID-19. Simpulan penelitian ini penggunaan ACEI dan ARB tidak memengaruhi mortalitas maupun progresivitas penyakit COVID-19 dan disarankan untuk tetap dilanjutkan.Kata kunci: ACEI, ARB, COVID-19, hipertensi, hipertensi pada COVID-19

Angioedema induced by angiotensin-converting enzyme inhibitors: an analysis of hospitalizations during the COVID-19 pandemic

2021 ◽  
Author(s):  
Tatsiana М. Sabalenka ◽  
Volha V. Zakharava ◽  
Natallia R. Prakoshyna
Keyword(s):  
Angiotensin Converting Enzyme ◽  
Enzyme Inhibitors ◽  
Enzyme Inhibitor ◽  
Angiotensin Receptor Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Converting Enzyme ◽  
Angiotensin Receptor ◽  
Converting Enzyme Inhibitors ◽  
Converting Enzyme Inhibitor ◽  
Receptor Blockers

Backgraund: The pathogenesis of angioedema induced by angiotensin-converting enzyme inhibitors is based on the accumulation of bradykinin as a result of angiotensin-converting enzyme blockade. The SARS-CoV-2 virus by binding to the angiotensin-converting enzyme 2 receptor, may inhibit its production, which in turn leads to an increase in bradykinin levels. Thus, infection with SARS-CoV-2 may be a likely trigger for the development of angioedema. Aims: to analyze the cases of hospitalizations of patients with angioedema associated with the use of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers during the COVID-19 pandemic. Materials and methods: a retrospective analysis of the medical records of inpatient patients admitted to the Vitebsk Regional Clinical Hospital in May-December 2020 with isolated (without urticaria) angioedema while receiving angiotensin-converting enzyme inhibitors or angiotensin receptor blockers was performed. All patients received smears from the naso- and oropharynx for COVID-19 by polymerase chain reaction. Results: there were admitted 15 patients (9 men and 6 women) aged 44-72 years for emergency indications, which was 53.6% among all patients with isolated angioedema. In two cases, a concomitant diagnosis of mild COVID-19 infection was established with the predominance symptoms of angioedema in the clinical picture with localization in the face, tongue, sublingual area, soft palate. All patients had a favorable outcome of the disease. Conclusions: patients with аngiotensin-converting enzyme inhibitor-induced angioedema may need to be hospitalized to monitor upper respiratory tract patency. There were cases of a combination of аngiotensin-converting enzyme inhibitor-induced angioedema and mild COVID-19 infection. Issues requiring additional research: the effect of SARS-CoV-2 infection on the levels of bradykinin and its metabolites; the trigger role of COVID-19 infection in the development of angioedema in patients receiving angiotensin-converting enzyme inhibitors/angiotensin receptor blockers; recommendations for the management of patients with аngiotensin-converting enzyme inhibitor-induced angioedema and a positive result for COVID-19.

Prognostic effect of angiotensin-converting-enzyme inhibitors (ACEI) and diuretics in patients with pancreatic cancer.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 420-420 ◽  
Author(s):  
Humaid Obaid Al-Shamsi ◽  
Akram Shalaby ◽  
Aneeqa Yousaf Dar ◽  
Manal Hassan ◽  
Robert A. Wolff ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Angiotensin Converting Enzyme ◽  
Enzyme Inhibitor ◽  
Beta Blockers ◽  
Angiotensin Receptor Blockers ◽  
Cancer Center ◽  
Prior History ◽  
Converting Enzyme ◽  
Antihypertensive Medications ◽  
All Cause Mortality

420 Background: Prior history of chronic medical conditions and medical treatment exposure has been significantly associated with the development and prognosis of different cancers. Population-based studies reported a reduced cancer-related mortality among patients with pancreatic cancer who were Statin or Metformin users as compared with non-users. We aimed to study the effect of antihypertensive medications on the survival outcome of pancreatic cancer. Methods: Under institutional ethical approval, medical records were reviewed and clinical characteristics at baseline (time of diagnosis) were retrieved. Blood pressure and antihypertensive medications use were documented including Angiotensin Converting Enzyme Inhibitor (ACEI), diuretics, Angiotensin Receptor Blockers (ARBs) and Beta-Blockers (BB). Hazard ratios (HRs) and 95% CIs were calculated by using Cox proportional hazard models with a backward stepwise selection procedure to identify independent prognostic factors for overall survival. Results: A total of 1,204 patients with adenocarcinoma of the pancreas were diagnosed at MD Anderson Cancer center between 1999 and 2009 were identified. The mean age value (± SD) is 61.9± 10 where 58.6% (N=705) were men and 87.5% (N=1,054) were white. The majority of patients were Caucasian (87%). 41.9% had metastatic disease. A total of 639 (53%) patients had chemotherapy with or without radiation. ACEI and diuretics use independently reduced all-cause mortality, ACEI by 24% with HR 0.76 (CI 0.63-0.91), and diuretics by 26% with HR 0.73 (CI 0.60- 0.89). Neither ARBs nor beta blockers use was statistically significant in reducing all-cause mortality (HR.80, CI 0.63 -1.0), BB HR 0.85 (CI 0.7-1.0). Conclusions: Our findings indicate a significant impact of anti-hypertensive medications including ACEI and diuretics on pancreatic cancer outcomes with improved survival in users versus non-users, this effect was independent of the cancer treatment received, tumour histology and site of metastasis. The potential antitumor activities of these agents in pancreatic cancer should be studied further.

scholarly journals Angiotensin-converting enzyme inhibitors (ACEI) or Angiotensin receptor blockers (ARBs) may be safe for COVID-19 patients

2020 ◽  
Author(s):  
Wenjun Wang ◽  
Xiaohui Zhao ◽  
Wei Wei ◽  
Weiwang Fan ◽  
Kai Gao ◽  
...  
Keyword(s):  
Angiotensin Converting Enzyme ◽  
Enzyme Inhibitor ◽  
Angiotensin Receptor Blockers ◽  
Converting Enzyme ◽  
Angiotensin Receptor ◽  
Converting Enzyme Inhibitors ◽  
Significant Difference ◽  
Group A ◽  
Receptor Blockers ◽  
Group B

Abstract Background: To investigate the effects of angiotensin-converting enzyme inhibitor (ACEI) and angiotensin receptor blockers (ARBs) administration to hypertension patients with the coronavirus disease 2019 (COVID-19) induced pneumonia.Methods: We recorded the recovery status of 67 inpatients with hypertension and COVID-19 induced pneumonia in the Raytheon Mountain Hospital in Wuhan during February 12, 2020 and March 30, 2020. Patients treated with ACEI or ARBs were categorized in group A (n = 22), while patients who were not administered either ACEI or ARBs were categorized into group B (n = 45). We did a comparative analysis of various parameters such as the pneumonia progression, length-of-stay in the hospital, and the level of alanine aminotransferase (ALT), serum creatinine (Cr), and creatine kinase (CK) between the day when these patients were admitted to the hospital and the day when the treatment ended.Results: These 67 hypertension cases counted for 33.17% of the total COVID-19 patients. There was no significant difference in the usage of drug treatment of COVID-19 between groups A and B (p > 0.05). During the treatment, 1 case in group A and 3 cases in group B progressed from mild pneumonia into severe pneumonia. Eventually, all patients were cured and discharged after treatment, and no recurrence of COVID-2019 induced pneumonia occurred after the discharge. The length of stays was shorter in group A as compared with group B, but there was no significant difference (p > 0.05). There was also no significant difference in other general parameters between the patients of the groups A and B on the day of admission to the hospital (p > 0.05). The ALT, CK, and Cr levels did not significantly differ between groups A and B on the day of admission and the day of discharge (p > 0.05). Conclusions: To treat the hypertension patients with COVID-19 caused pneumonia, anti-hypertensive drugs (ACEs and ARBs) may be used according to the relative guidelines. The treatment regimen with these drugs does not need to be altered for the COVID-19 patients.

scholarly journals Življenje ogrožajoč angioedem po zaviralcu angiotenzinove konvertaze: prikaz dveh primerov Life-threatening angioedema induced by angiotensin-converting enzyme inhibitor: two case reports

2016 ◽  
Vol 84 (12) ◽  
Author(s):  
Erik Rupnik ◽  
Stojan Kariž ◽  
Črtomir Iglič ◽  
Mihaela Zidarn
Keyword(s):  
Angiotensin Converting Enzyme ◽  
Enzyme Inhibitors ◽  
Enzyme Inhibitor ◽  
Case Reports ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Converting Enzyme ◽  
Converting Enzyme Inhibitors ◽  
Key Enzyme ◽  
Life Threatening

Background. Angioedema is a rare but potentially very serious complication of treatment with angiotensin converting enzyme inhibitors (ACEI). Angioedema is due to the accumulation of bradykinin, because angiotensin converting enzyme is the key enzyme for its degradation.Case reports. We present two patients with life-threatening angioedema while taking ACEI. Both patients had already had episodes of angioedema. Angioedema didn't respond to adrenaline. In both patients intubation was difficult.Conclusion. In the acute phase of angioedema due to ACEI it is necessary to protect the airways. Bradykinin receptor inhibitors shorten the duration of episodes of angioedema. In the long term it is essential to permanently avoid ACEI.

scholarly journals Could Anti‐Hypertensive Drug Therapy Affect the Clinical Prognosis of Hypertensive Patients With COVID‐19 Infection? Data From Centers of Southern Italy

2020 ◽  
Vol 9 (17) ◽  
Author(s):  
Celestino Sardu ◽  
Paolo Maggi ◽  
Vincenzo Messina ◽  
Pasquale Iuliano ◽  
Antonio Sardu ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Angiotensin Converting Enzyme ◽  
Enzyme Inhibitor ◽  
Angiotensin Receptor Blockers ◽  
Converting Enzyme ◽  
Angiotensin Receptor ◽  
Angiotensin Converting Enzyme 2 ◽  
Receptor Blockers ◽  
Worse Prognosis

BACKGROUND Coronavirus disease 2019 (COVID‐19) is the cause of a pandemic disease, with severe acute respiratory syndrome by binding target epithelial lung cells through angiotensin‐converting enzyme 2 in humans. Thus, patients with hypertension with COVID‐19 could have worse prognosis. Indeed, angiotensin‐converting enzyme inhibitors and/or angiotensin receptor blockers may interfere with angiotensin‐converting enzyme 2 expression/activity. Thus, patients with hypertension undergoing angiotensin‐converting enzyme inhibitor and/or angiotensin receptor blockers drug therapy may be at a higher risk of contracting a serious COVID‐19 infection and should be monitored. Moreover, in the present study we investigated the effects of angiotensin‐converting enzyme inhibitor versus angiotensin receptor blockers versus calcium channel blockers on clinical outcomes as mechanical ventilation, intensive care unit admissions, heart injury, and death in 62 patients with hypertension hospitalized for COVID‐19 infection. METHODS AND RESULTS The multicenter study was prospectively conducted at Department of Infectious Diseases of Sant'Anna Hospital of Caserta, and of University of Campania "Luigi Vanvitelli" of Naples, at Department of Advanced Surgical and Medical Sciences of University of Campania "Luigi Vanvitelli," Naples, and at General Medical Assistance Unit "FIMG," Naples, Italy. Lowest values of left ventricle ejection fraction predicted deaths (1.142, 1.008–1.294, P <0.05), while highest values of interleukin‐6 predicted the admission to intensive care unit (1.617, 1.094–2.389), mechanical ventilation (1.149, 1.082–1.219), heart injuries (1.367, 1.054–1.772), and deaths (4.742, 1.788–8.524). CONCLUSIONS Anti‐hypertensive drugs didn't affect the prognosis in patients with COVID‐19. Consequently, tailored anti‐inflammatory and immune therapies in addition to chronic antihypertensive therapy, could prevent a worse prognosis, as well as improve the clinical outcomes in patients with hypertension with COVID‐19 infection.

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