Association of Renin Angiotensin Aldosterone System Inhibitors and Outcomes of Hospitalized Patients with COVID-19 (2024)

Original languageEnglish
Pages (from-to)E744-E758
JournalCritical Care Medicine
Volume50
Issue number10
DOIs
StatePublished - Oct 1 2022

ASJC Scopus Subject Areas

  • Critical Care and Intensive Care Medicine

Keywords

  • antihypertensive agents
  • COVID-19
  • mortality
  • outcome
  • renin-angiotensin-aldosterone system inhibitors

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Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator Group (2022). Association of Renin Angiotensin Aldosterone System Inhibitors and Outcomes of Hospitalized Patients with COVID-19. Critical Care Medicine, 50(10), E744-E758. https://doi.org/10.1097/CCM.0000000000005627

Association of Renin Angiotensin Aldosterone System Inhibitors and Outcomes of Hospitalized Patients with COVID-19. / Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator Group.
In: Critical Care Medicine, Vol. 50, No. 10, 01.10.2022, p. E744-E758.

Research output: Contribution to journalArticlepeer-review

Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator Group 2022, 'Association of Renin Angiotensin Aldosterone System Inhibitors and Outcomes of Hospitalized Patients with COVID-19', Critical Care Medicine, vol. 50, no. 10, pp. E744-E758. https://doi.org/10.1097/CCM.0000000000005627

Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator Group. Association of Renin Angiotensin Aldosterone System Inhibitors and Outcomes of Hospitalized Patients with COVID-19. Critical Care Medicine. 2022 Oct 1;50(10):E744-E758. doi: 10.1097/CCM.0000000000005627

Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator Group. / Association of Renin Angiotensin Aldosterone System Inhibitors and Outcomes of Hospitalized Patients with COVID-19. In: Critical Care Medicine. 2022 ; Vol. 50, No. 10. pp. E744-E758.

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title = "Association of Renin Angiotensin Aldosterone System Inhibitors and Outcomes of Hospitalized Patients with COVID-19",

keywords = "antihypertensive agents, COVID-19, mortality, outcome, renin-angiotensin-aldosterone system inhibitors",

author = "{Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator Group} and Neha Gupta and Lisa Settle and Brown, {Brent R.} and Armaignac, {Donna L.} and Michael Baram and Perkins, {Nicholas E.} and Margit Kaufman and Melamed, {Roman R.} and Christie, {Amy B.} and Danesh, {Valerie C.} and Denson, {Joshua L.} and Cheruku, {Sreekanth R.} and Karen Boman and Kumar, {Vishakha K.} and Vikas Bansal and Rahul Kashyap and Walkey, {Allan J.} and Domecq, {Juan P.} and Aston, {Christopher E.} and Mesland, {Jean Baptiste} and Pierre Henin and H{\'e}l{\`e}ne Petre and Isabelle Buelens and Gerard, {Anne Catherine} and Philippe Clevenbergh and Granado, {Rolando Claure Del} and Mercado, {Jose A.} and Esdenka Vega-Terrazas and Iturricha-Caceres, {Maria F.} and Ruben Garza and Eric Chu and Victoria Chan and Gavidia, {Oscar Y.} and Felipe Pachon and Sanchez, {Yeimy A.} and Danijel Kne{\v z}evi{\'c} and {El Kassas}, Mohamed and Mohamed Badr and Ahmed Tawheed and Hend Yahia and Dimitrios Kantas and Vasileios Koulouras and Estela Pineda and {Reyes Guillen}, {Gabina Mar{\'i}a} and Soto, {Helin Archaga} and {Vallecillo Lizardo}, {Ana Karen} and Csaba Kopitk{\'o} and {\'A}gnes Bencze and Nohemi Sadule-Rios and Rojas, {Lourdes M.}",

note = "Publisher Copyright: Copyright {\textcopyright} 2022 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.",

year = "2022",

month = oct,

day = "1",

doi = "10.1097/CCM.0000000000005627",

language = "English",

volume = "50",

pages = "E744--E758",

journal = "Critical Care Medicine",

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AU - Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator Group

AU - Gupta, Neha

AU - Settle, Lisa

AU - Brown, Brent R.

AU - Armaignac, Donna L.

AU - Baram, Michael

AU - Perkins, Nicholas E.

AU - Kaufman, Margit

AU - Melamed, Roman R.

AU - Christie, Amy B.

AU - Danesh, Valerie C.

AU - Denson, Joshua L.

AU - Cheruku, Sreekanth R.

AU - Boman, Karen

AU - Kumar, Vishakha K.

AU - Bansal, Vikas

AU - Kashyap, Rahul

AU - Walkey, Allan J.

AU - Domecq, Juan P.

AU - Aston, Christopher E.

AU - Mesland, Jean Baptiste

AU - Henin, Pierre

AU - Petre, Hélène

AU - Buelens, Isabelle

AU - Gerard, Anne Catherine

AU - Clevenbergh, Philippe

AU - Granado, Rolando Claure Del

AU - Mercado, Jose A.

AU - Vega-Terrazas, Esdenka

AU - Iturricha-Caceres, Maria F.

AU - Garza, Ruben

AU - Chu, Eric

AU - Chan, Victoria

AU - Gavidia, Oscar Y.

AU - Pachon, Felipe

AU - Sanchez, Yeimy A.

AU - Knežević, Danijel

AU - El Kassas, Mohamed

AU - Badr, Mohamed

AU - Tawheed, Ahmed

AU - Yahia, Hend

AU - Kantas, Dimitrios

AU - Koulouras, Vasileios

AU - Pineda, Estela

AU - Reyes Guillen, Gabina María

AU - Soto, Helin Archaga

AU - Vallecillo Lizardo, Ana Karen

AU - Kopitkó, Csaba

AU - Bencze, Ágnes

AU - Sadule-Rios, Nohemi

AU - Rojas, Lourdes M.

N1 - Publisher Copyright:Copyright © 2022 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

PY - 2022/10/1

Y1 - 2022/10/1

KW - antihypertensive agents

KW - COVID-19

KW - mortality

KW - outcome

KW - renin-angiotensin-aldosterone system inhibitors

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DO - 10.1097/CCM.0000000000005627

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C2 - 35894609

AN - SCOPUS:85138445319

SN - 0090-3493

VL - 50

SP - E744-E758

JO - Critical Care Medicine

JF - Critical Care Medicine

IS - 10

ER -

Association of Renin Angiotensin Aldosterone System Inhibitors and Outcomes of Hospitalized Patients with COVID-19 (2024)

FAQs

Do ACE inhibitors and ARBs increase the likelihood of severe COVID-19? ›

Clinical outcomes

The proportion of patients with the mild form of COVID-19 was lower in patients taking ACEI/ARB drugs (54.4% vs. 68.8%), while the incidence of moderate and severe forms was significantly higher in patients taking ACEI/ARB drugs (P-value = 0.012).

Are treatment with ACE inhibitors or ARBs and risk of severe lethal COVID-19 a meta analysis? ›

Acknowledging these caveats, the present meta-analysis, based on 10 studies and almost 10 000 hypertensive subjects, did not find any association between COVID-19 severity or mortality and treatment with ARBs, ACE inhibitors or both, strongly supporting the recommendation of several scientific societies to continue ...

What is the interaction between sars CoV 2 and the renin-angiotensin-aldosterone system? ›

The severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) that is responsible for coronavirus disease 2019 (COVID‐19) through binding to angiotensin‐converting enzyme 2 (ACE2), a counter regulator of renin‐angiotensin aldosterone system (RAAS), enters the cells and infects them.

What is the problem with renin-angiotensin-aldosterone system? ›

Dysregulation of the RAAS has been implicated in the pathophysiology of various cardiovascular disorders including hypertension, AMI, congestive heart failure (CHF) and stroke, as well as renal disorders especially DN.

Who should avoid ARBs? ›

Some people taking the angiotensin 2 receptor blocker olmesartan (Benicar) have reported digestive problems. Talk to your health care team if you have severe diarrhea or lose a lot of weight while taking this medicine. Don't take angiotensin 2 receptor blockers if you're pregnant or you plan to become pregnant.

What is one of the biggest risk factors for severe COVID-19? ›

Age is the strongest risk factor for severe COVID-19 outcomes. Patients with one or multiple certain underlying medical conditions are also at higher risk.

Why is ACE preferred over ARBs? ›

ACE inhibitors should be used in patients with hypertension because they reduce all-cause mortality, whereas ARBs do not.

What is a currently recommended medication for patients with severe COVID-19 who are on high flow oxygen due to hypoxia? ›

Tofacitinib appears to demonstrate the most benefit in those with severe COVID-19 on supplemental or high-flow oxygen. Patients treated with tofacitinib should be on at least prophylactic dose anticoagulant.

What medication is used for high risk Covid patients? ›

Act fast if you have symptoms for COVID-19.
TherapeuticType of treatmentStart time after symptoms first appear
Lagevrio (molnupiravir)Oral antiviral (pills)As soon as possible and up to 5 days
Veklury® (remdesivir)IV infusion antiviralAs soon as possible and up to 7 days
1 more row

Which drug affects the renin angiotensin aldosterone system? ›

ACE-inhibitors (benazepril, captopril, cilazapril, delapril, enalapril, fosinopril, imidapril, lisinopril, moexipril, perindopril, quinapril, ramipril, spirapril, trandolapril or zofenopril) and the direct renin inhibitor aliskiren block the actions of specific enzymes involved in the production of angiotensin II in ...

How does the renin angiotensin aldosterone system affect the kidneys? ›

Abstract. The renin-angiotensin-aldosterone system regulates renal vasomotor activity, maintains optimal salt and water homeostasis, and controls tissue growth in the kidney. However, pathologic consequences can result from overactivity of this cascade, involving it in the pathophysiology of kidney disease.

What are the effects of renin and aldosterone? ›

Renin cleaves the blood protein angiotensinogen to form angiotensin I. It is then converted by a second enzyme to angiotensin II, which causes blood vessels to constrict, and stimulates aldosterone production. Overall, this raises blood pressure and keeps sodium and potassium at normal levels.

What drugs block the renin angiotensin system? ›

Azilsartan medoxomil, candesartan cilexetil, eprosartan, irbesartan, losartan potassium, olmesartan medoxomil, telmisartan, and valsartan are angiotensin-II receptor antagonists with many properties similar to those of the ACE inhibitors.

What triggers the renin-angiotensin-aldosterone system into action? ›

Typically, RAAS is activated when there is a drop in blood pressure (reduced blood volume) to increase water and electrolyte reabsorption in the kidney; which compensates for the drop in blood volume, thus increasing blood pressure.

What are the side effects of renin angiotensin system? ›

Direct renin inhibitors
  • Angioedema.
  • Hypotension.
  • Hyperkalemia.
  • ↓ GFR. (with ↑ creatinine. )
  • Teratogenicity.
  • Rash.
  • Diarrhea.
Nov 6, 2023

Does losartan reduce the severity of COVID-19 in hypertensive patients? ›

Conclusions: The results showed that losartan reduced the chance of mortality in hypertensive patients. It is recommended that the effect of losartan and other blood pressure medicines on COVID-19 patients be investigated in larger studies as well as laboratory investigations.

Should patients taking ACE I and ARBs who contract COVID-19 continue treatment unless otherwise advised by their physician? ›

The AHA, the HFSA and the ACC recommend continuation of angiotensin converting enzyme inhibitors (ACE-i) or angiotensin receptor blocker (ARB) medications for all patients already prescribed for indications such as heart failure, hypertension or ischemic heart disease.

Should I take lisinopril if I have COVID? ›

There is currently no evidence that ACE inhibitors do make COVID-19 worse.

Is ACE2 expression increased in the lungs of patients with comorbidities associated with severe COVID-19? ›

This finding suggests that patients with such comorbidities may have higher chances of developing severe COVID-19. Correlation and network analyses revealed many potential regulators of ACE2 in the human lung, including genes related to histone modifications, such as HAT1, HDAC2, and KDM5B.

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