scholarly journals CLINICAL FEATURES OF NOVEL CORONAVIRUS 2019-INFECTED CASES WITH PRE-EXISTING CARDIOVASCULAR DISEASE, DISAGGREGATED BY GENDER

2021 ◽  
Vol 54 (2) ◽  
pp. 180-185
Author(s):  
Elham Mohammadyari ◽  
Mohammad Reza Kaffashian ◽  
Iraj Ahmadi ◽  
Azra Kenarkoohi ◽  
Askar Soufinia ◽  
...  
Keyword(s):  
Clinical Features ◽  
Clinical Laboratory ◽  
Renin Angiotensin System ◽  
Angiotensin System ◽  
Men And Women ◽  
Blood Pressures ◽  
Males And Females ◽  
The Mean ◽  
Novel Coronavirus ◽  
Common Laboratory

Objectives: This study was conducted to evaluate the clinical features of 68 coronavirus 2019-infected cardiac cases on gender basis. Methodology: Clinical, laboratory and electrocardiographic data of 68 COVID-19 patients with pre-existing cardiovascular diseases, analyzed and compared by gender-wise. Results: Dry cough (78% of male, 80% females) and fever (62% of male, 75% females) were the most common symptoms. Out of these 97% of them needed O2 supplementation. O2 saturation in patients with O2 therapy was 85%; 31% of men and 11% of women experienced intubation. The most common laboratory abnormalities, were neutrophilia, leukocytosis, lymphopenia, thrombocytopenia, decreased hemoglobin level, increased creatinine and urea, in men and women. Troponin level was different between male and female. Pneumonia was found in 86-87% patients. Approximately, Males and female, respectively53.10 and 52.8%, shown sinus tachycardia (ST arrythmia). PVC arrythmia was found in 2.9% of total patients. BBB arrythmia was found in 31.20% of males vs. 11.10% of females. The mean systole/diastole blood pressures respectively were 130±4/79.7 ±2 in males and 134±4/81±3 in females. Heart axis changes was identified in 43.8% and 27.8% of males and females respectively. Conclusion: Severity of symptoms and outcomes of COVID-19 in cardiac patients showed some differences between men and women which could be associated with differences in immune responses, respiratory tract properties, renin angiotensin system, sex hormones and lifestyle.  However, more studies to categorize gender differences are required.

scholarly journals Pathological Role of Angiotensin II in Severe COVID-19

TH Open ◽  
2020 ◽  
Vol 04 (02) ◽  
pp. e138-e144 ◽  
Author(s):  
Wolfgang Miesbach
Keyword(s):  
Angiotensin Ii ◽  
Angiotensin Converting Enzyme ◽  
Treatment Options ◽  
Renin Angiotensin System ◽  
Target Cells ◽  
Converting Enzyme ◽  
Angiotensin System ◽  
Angiotensin Converting Enzyme 2 ◽  
Renin Angiotensin ◽  
Novel Coronavirus

AbstractThe activated renin–angiotensin system induces a prothrombotic state resulting from the imbalance between coagulation and fibrinolysis. Angiotensin II is the central effector molecule of the activated renin–angiotensin system and is degraded by the angiotensin-converting enzyme 2 to angiotensin (1–7). The novel coronavirus infection (classified as COVID-19) is caused by the new coronavirus SARS-CoV-2 and is characterized by an exaggerated inflammatory response that can lead to severe manifestations such as acute respiratory distress syndrome, sepsis, and death in a proportion of patients, mostly elderly patients with preexisting comorbidities. SARS-CoV-2 uses the angiotensin-converting enzyme 2 receptor to enter the target cells, resulting in activation of the renin–angiotensin system. After downregulating the angiotensin-converting enzyme 2, the vasoconstrictor angiotensin II is increasingly produced and its counterregulating molecules angiotensin (1–7) reduced. Angiotensin II increases thrombin formation and impairs fibrinolysis. Elevated levels were strongly associated with viral load and lung injury in patients with severe COVID-19. Therefore, the complex clinical picture of patients with severe complications of COVID-19 is triggered by the various effects of highly expressed angiotensin II on vasculopathy, coagulopathy, and inflammation. Future treatment options should focus on blocking the thrombogenic and inflammatory properties of angiotensin II in COVID-19 patients.

scholarly journals Clinical Features of Maintenance Hemodialysis Patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China

2020 ◽  
Vol 15 (8) ◽  
pp. 1139-1145 ◽  
Author(s):  
Jun Wu ◽  
Jushuang Li ◽  
Geli Zhu ◽  
Yanxia Zhang ◽  
Zhimin Bi ◽  
...  
Keyword(s):  
Clinical Features ◽  
Troponin I ◽  
Clinical Laboratory ◽  
Cardiac Injury ◽  
Hemodialysis Patients ◽  
Hospitalized Patients ◽  
Maintenance Hemodialysis ◽  
Computed Tomographic ◽  
Risk Of Death ◽  
Novel Coronavirus

Background and objectivesPrevious reports on the outbreak of coronavirus disease 2019 were on the basis of data from the general population. Our study aimed to investigate the clinical features of patients on maintenance hemodialysis.Design, setting, participants, & measurements In this retrospective, single-center study, we included 49 hospitalized patients on maintenance hemodialysis and 52 hospitalized patients without kidney failure (controls) with confirmed coronavirus disease 2019 at Tongren Hospital of Wuhan University from January 30, 2020 to March 10, 2020. Demographic, clinical, laboratory, and radiologic characteristics and treatment and outcomes data were analyzed. The final date of follow-up was March 19, 2020.ResultsThe median age of 101 patients was 62 years (interquartile range, 49–72). All patients were local residents of Wuhan. In terms of common symptoms, there were differences between patients on hemodialysis and controls (fatigue [59% versus 83%], dry cough [49% versus 71%], and fever [47% versus 90%]). Lymphocyte counts were decreased (0.8×109/L [patients on hemodialysis] versus 0.9×109/L [controls], P=0.02). Comparing patients on hemodialysis with controls, creatine kinase–muscle and brain type, myoglobin, hypersensitive troponin I, B-type natriuretic peptide, and procalcitonin were increased, and the percentage of abnormalities in bilateral lung was higher in computed tomographic scan (82% versus 69%, P=0.15) and unilateral lung was lower (10% versus 27%, P=0.03). Common complications including shock, acute respiratory distress syndrome, arrhythmia, and acute cardiac injury in patients on hemodialysis were significantly higher. Compared with controls, more patients on hemodialysis received noninvasive ventilation (25% versus 6%, P=0.008). As of March 19, 2020, three patients on hemodialysis (6%) were transferred to the intensive care unit and received invasive ventilation. Seven patients on hemodialysis (14%) had died.ConclusionsThe main symptoms of coronavirus disease 2019 pneumonia, including fever and cough, were less common in patients on hemodialysis. Patients on hemodialysis with coronavirus disease 2019 were at higher risk of death.

Role of renin-angiotensin system in response to hemorrhage in fetal sheep

1981 ◽  
Vol 240 (6) ◽  
pp. H848-H854 ◽  
Author(s):  
H. S. Iwamoto ◽  
A. M. Rudolph
Keyword(s):  
Venous Blood ◽  
Renin Angiotensin System ◽  
Plasma Renin ◽  
Fetal Life ◽  
Fetal Sheep ◽  
Angiotensin System ◽  
Renin Angiotensin ◽  
Plasma Angiotensin ◽  
Blood Pressures ◽  
Placental Blood

During fetal life, the autonomic nervous system is not fully mature, and it is likely that hormonal mechanisms play an important role in controlling cardiovascular function. In chronically instrumented fetal sheep, hemorrhage increased plasma renin activity and plasma angiotensin concentration significantly from 6.7 +/- 2.5 to 15.2 +/- 3.1 ng.ml-1.h-1 and from 74 +/- 19 to 182 +/- 43 pg/ml, respectively. Both mean arterial and venous blood pressures decreased initially from 45 to 35 Torr and from 3.5 to 2.5 Torr, respectively; then both returned to control values. Fetal heart rate decreased initially from 174 beats/min and then increased to 186 beats/min. To determine whether angiotensin had a role in mediating these responses to hemorrhage, we hemorrhaged a second group of fetuses before and during infusion of saralasin, a competitive antagonist of angiotensin. Hemorrhage during infusion of saralasin decreased heart rat from 170 to 145 beats/min and further decreased mean arterial pressure to 30 Torr. Cardiac output decreased from 436 +/- 25 to 368 +/- 30 ml.min-1.kg-1, and umbilical-placental blood flow decreased from 205 +/- 20 to 145 +/- 10 ml.min-1.kg-1. We conclude that the renin-angiotensin system plays a major role in the response to hemorrhage in fetal sheep.

Lithium Carbonate – a Competitive Aldosterone Antagonist?

1988 ◽  
Vol 153 (2) ◽  
pp. 205-207 ◽  
Author(s):  
Paul M. Stewart ◽  
Sheila M. Atherden ◽  
Susan E. Stewart ◽  
Lawrence Whalley ◽  
Christopher R. W. Edwards ◽  
...  
Keyword(s):  
Matched Control ◽  
Renin Angiotensin System ◽  
Distal Tubule ◽  
Plasma Renin ◽  
Lithium Carbonate ◽  
Treated Group ◽  
Normal Blood Pressure ◽  
Angiotensin System ◽  
Plasma Electrolytes ◽  
Blood Pressures

Plasma renin activity (PRA), aldosterone (aldo) levels, electrolyte levels, and blood pressures were measured in 16 patients with affective disorders taking lithium prophylactically, and in 16 age and sex-matched control subjects. PRA and aldo levels were significantly elevated in the lithium-treated group. There was no difference between the groups in plasma electrolytes or erect and supine blood pressures, arguing against secondary aldosteronism. In the lithium-treated group, there was a significant positive correlation between both PRA and plasma aldo vs serum lithium. We postulate that lithium inhibits the action of aldosterone on the distal tubule in the kidney. Activation of the renin angiotensin system maintains normal blood pressure and plasma electrolytes.

Gender comparisons of adolescents’ anthropometry and blood pressure in Osun State, South-Western Nigeria

2015 ◽  
Vol 27 (3) ◽  
pp. 247-251 ◽  
Author(s):  
Bridget Omisore ◽  
Akinlolu G. Omisore ◽  
Emmanuel Akintunde Abioye-Kuteyi
Keyword(s):  
Blood Pressure ◽  
Cross Sectional Study ◽  
Overweight And Obesity ◽  
Female Adolescents ◽  
Anthropometric Indices ◽  
Cross Sectional ◽  
Multi Stage ◽  
Blood Pressures ◽  
Males And Females ◽  
The Mean

Abstract Background: Adolescents are in their formative years, and they experience several changes including anthropometric changes. Significant weight gain occurs in adolescence, and increasingly, obesity and consequent increase in blood pressure (BP) are found in adolescents. Objective: This study compared anthropometric and BP measurements in male and female adolescents. Methods: A cross-sectional study of 1000 adolescents (510 males and 490 females) were selected by multi-stage sampling from eight secondary schools. Pertinent information was collected with the aid of a structured questionnaire, anthropometric and blood pressure measurements. Data were analyzed using SPSS 16.0 version, and the means of anthropometric indices and blood pressures in males and females were compared using independent t-test. Results: The mean age for male respondents was 13.83 years (SD 2.12) and for females 13.62 (SD 1.96). Generally, anthropometric indices gradually increased from the lower ages to the higher ages in both males and females. The mean height was the same for both males and females (1.54 m), while the mean weight, body mass index (BMI), and waist circumference were significantly higher in females than in males (p<0.05). A significantly higher proportion of females compared with males were overweight (10.2%, 5.3%) and obese (3.9%, 2.0%), respectively. The overall prevalence of “hypertension,” was 4.1% and more females (70.7%) had “hypertension” than males (29.3%). Conclusion: Females were heavier and constituted the greater proportion of those who had elevated BP. Adequate attention needs to be given to the challenging problems of overweight and obesity to forestall development of hypertension in adolescents, especially female adolescents.

HYPERALDOSTERONISM IN THE SODIUM-DEPLETED RAT: MODE OF ALDOSTERONE-STIMULATING ACTION OF FRUSEMIDE

1979 ◽  
Vol 82 (1) ◽  
pp. 7-15 ◽  
Author(s):  
A. SPÄT ◽  
ÉVA TARJÁN ◽  
G. TÓTH
Keyword(s):  
Adrenal Glands ◽  
Renin Angiotensin System ◽  
Plasma Renin ◽  
Prostaglandin Synthesis ◽  
Angiotensin System ◽  
Adrenal Response ◽  
The Mean ◽  
Glomerulosa Cells ◽  
Mean Concentration ◽  
Vehicle Treated Control

SUMMARY The mechanism of diuretic-induced hyperaldosteronism was examined in dexamethasone-pretreated rats. The diuretic drug frusemide brought about a rapid increase in plasma renin activity and aldosterone concentration in serum. Half an hour after the administration of frusemide the mean concentration of aldosterone was 25 times higher than in vehicle-treated control animals. Administration of SQ 20,881, an inhibitor of angiotensin converting enzyme, prevented the adrenal response to frusemide. The response of aldosterone was completely blocked by indomethacin. This drug reduced renin release and probably also inhibited the effect on the adrenal glands of angiotensin, released in response to frusemide. Our results indicate that the effects of diuretics on the adrenal glomerulosa cells are mediated by the renin–angiotensin system also in the rat. Hyperaldosteronism is dependent on the maintenance of prostaglandin synthesis. ACTH has no essential role in this response.

scholarly journals Moderate Intensity Aerobic Exercise Potential Favorable Effect Against COVID-19: The Role of Renin-Angiotensin System and Immunomodulatory Effects

2021 ◽  
Vol 12 ◽  
Author(s):  
Hamid Arazi ◽  
Akram Falahati ◽  
Katsuhiko Suzuki
Keyword(s):  
Physical Exercise ◽  
Experimental Studies ◽  
Renin Angiotensin System ◽  
Potential Effect ◽  
Moderate Intensity ◽  
Favorable Effect ◽  
Angiotensin System ◽  
Angiotensin Converting Enzyme 2 ◽  
Renin Angiotensin ◽  
Novel Coronavirus

The coronavirus disease (COVID-19) pandemic is caused by a novel coronavirus (CoV) named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As the angiotensin converting enzyme 2 (ACE2) is the cellular receptor of SARS-CoV-2, it has a strong interaction with the renin angiotensin system (RAS). Experimental studies have shown that the higher levels of ACE2 or increasing ACE2/ACE1 ratio improve COVID-19 outcomes through lowering inflammation and death. Aerobic moderate intensity physical exercise fights off infections by two mechanisms, the inhibition of ACE/Ang II/AT1-R pathway and the stimulation of ACE2/Ang-(1–7)/MasR axis. Exercise can also activate the anti-inflammatory response so that it can be a potential therapeutic strategy against COVID-19. Here, we summarize and focus the relation among COVID-19, RAS, and immune system and describe the potential effect of aerobic moderate intensity physical exercise against CoV as a useful complementary tool for providing immune protection against SARS-CoV-2 virus infection, which is a novel intervention that requires further investigation.

scholarly journals Health concerns regarding the effect of the COVID-19 pandemic on male fertility

2021 ◽  
Author(s):  
Hamidreza Mosleh ◽  
Fatemeh Moradi ◽  
Mehdi Mehdizadeh ◽  
Marziyeh Ajdary ◽  
Alaa Moeinzadeh ◽  
...  
Keyword(s):  
Male Infertility ◽  
Sertoli Cells ◽  
Leydig Cells ◽  
Renin Angiotensin System ◽  
High Expression ◽  
Angiotensin System ◽  
Angiotensin Converting Enzyme 2 ◽  
Testicular Cells ◽  
Novel Coronavirus ◽  
High Expression Level

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus found in China in 2019. The disease caused by SARS-CoV-2, coronavirus disease 2019 (COVID-19), has been found to be closely related to the cells that secrete angiotensin-converting enzyme 2 (ACE2). ACE2 is involved in the renin-angiotensin system and is widely secreted in several tissues, including the testis, which has raised concerns because organs with high expression of the ACE2 receptor are susceptible to infection. Analyses have shown that in testicular cells, such as spermatogonia, seminiferous duct cells, Sertoli cells, and Leydig cells, there is a high expression level of ACE2. Therefore, SARS-CoV-2 may damage male reproductive tissues and cause infertility. Since male infertility is an important problem, scientists are evaluating whether COVID-19 may influence male infertility through the ACE2 receptor.

scholarly journals SARS-CoV-2 perturbs the renin-angiotensin system and energy metabolism

2020 ◽  
Vol 319 (1) ◽  
pp. E43-E47 ◽  
Author(s):  
Jun Mori ◽  
Gavin Y. Oudit ◽  
Gary D. Lopaschuk
Keyword(s):  
Diabetes Mellitus ◽  
Energy Metabolism ◽  
Viral Infections ◽  
Renin Angiotensin System ◽  
Daily Lives ◽  
Angiotensin System ◽  
Renin Angiotensin ◽  
Obesity And Diabetes ◽  
Ras Family ◽  
Novel Coronavirus

The COVID-19 pandemic, caused by the novel coronavirus, SARS-CoV-2, is threating our health systems and daily lives and is responsible for causing substantial morbidity and mortality. In particular, aged individuals and individuals with comorbidities, including obesity, diabetes mellitus, and hypertension, have significantly higher risks of hospitalization and death than normal individuals. The renin-angiotensin system (RAS) plays a pivotal role in the pathogenesis of diabetes mellitus, obesity, and hypertension. Angiotensin-converting enzyme 2 (ACE2), belonging to the RAS family, has received much attention during this COVID-19 pandemic, owing to the fact that SARS-CoV-2 uses ACE2 as a receptor for cellular entry. Additionally, the RAS greatly affects energy metabolism in certain pathological conditions, including cardiac failure, diabetes mellitus, and viral infections. This article discusses the potential mechanisms by which SARS-CoV-2 modulates the RAS and energy metabolism in individuals with obesity and diabetes mellitus. The article aims to highlight the appropriate strategies for combating the COVID-19 pandemic in the clinical setting and emphasize on the areas that require further investigation in relation to COVID-19 infections in patients with obesity and diabetes mellitus from the viewpoint of endocrinology and metabolism.

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