Renin-angiotensin system inhibitor discontinuation in COVID-19 did not modify systemic ACE2 in a randomized controlled trial.
Human metabolism
Virology
Journal
iScience
ISSN: 2589-0042
Titre abrégé: iScience
Pays: United States
ID NLM: 101724038
Informations de publication
Date de publication:
17 Nov 2023
17 Nov 2023
Historique:
received:
25
04
2023
revised:
01
09
2023
accepted:
02
10
2023
medline:
23
10
2023
pubmed:
23
10
2023
entrez:
23
10
2023
Statut:
epublish
Résumé
Despite the similar clinical outcomes after renin-angiotensin system (RAS) inhibitor (RASi) continuation or withdrawal in COVID-19, the effects on angiotensin-converting enzyme 2 (ACE2) and RAS metabolites remain unclear. In a substudy of the randomized controlled Austrian Corona Virus Adaptive Clinical Trial (ACOVACT), patients with hypertension and COVID-19 were randomized 1:1 to either RASi continuation (n = 30) or switch to a non-RASi medication (n = 29). RAS metabolites were analyzed using a mixed linear regression model (n = 30). Time to a sustained clinical improvement was equal and ACE2 did not differ between the groups but increased over time in both. Overall ACE2 was higher with severe COVID-19. ACE-S and Ang II levels increased as expected with ACE inhibitor discontinuation. These data support the safety of RASi continuation in COVID-19, although RASi were frequently discontinued in our post hoc analysis. The study was not powered to draw definite conclusions on clinical outcomes using small sample sizes.
Identifiants
pubmed: 37867935
doi: 10.1016/j.isci.2023.108146
pii: S2589-0042(23)02223-X
pmc: PMC10585392
doi:
Types de publication
Journal Article
Langues
eng
Pagination
108146Informations de copyright
© 2023 The Author(s).
Déclaration de conflit d'intérêts
M.P. is employed by Attoquant Diagnostics, Vienna/Austria, a company that received payments for RAS-Fingerprint and ACE2 quantification.
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