Suspension of Angiotensin Receptor Blockers and Angiotensin-converting Enzyme Inhibitors and Adverse Outcomes in Hospitalized Patients With Coronavirus Infection.
Several interactions by pre-existing therapies for chronic diseases, therapies used by
SARS-CoV2 infection generate doubts about risks and benefits. Among these situations in which
the current data indicate a situation of equipoise would be about the maintenance or
suspension of ACEI / BRA in patients with SARS-CoV2 infection. Increasing the expression of
ECA-2 could increase the binding to the virus, however, there are studies that indicate this
increase in ECA-2 could be protective. So far, there is no clinical evidence to confirm any
of the theories, and this question can only be clarified through a randomized clinical trial.
The objective is to evaluate the impact of the suspension of the use of
angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (BRA) on the
length of hospital stay and on the mortality of patients with SARS-CoV2 infection.
Other: Suspension or Maintenance of Angiotensin Receptor Blockers and Angiotensin-converting Enzyme Inhibitors
Suspension or Maintenance of Angiotensin Receptor Blockers and Angiotensin-converting Enzyme Inhibitors
Inclusion Criteria:
- Patients hospitalized with COVID-19 diagnosis using ACE inhibitors or blockers of
angiotensin receptor;
- Patients ≥ 18 years old;
- Maximum use of 3 antihypertensive drugs;
- Sign the consent form.
Exclusion Criteria:
- Severe evolution with orotracheal intubation, use of mechanical ventilation and / or
hemodynamic instability in the first 24 hours until COVID-19 diagnosis confirmation;
- Patients hospitalized per decompensated congestive heart failure in the last 12
months;
- Use of Sacubitril/Valsartan
- Pregnancy
- Recent acute renal failure and shock
Idor
São Paulo, Brazil
Investigator: Renato D. Lopes, MD, PhD
Renato D. Lopes, MD, PhD
55 11 5904 7339
renato.lopes@duke.edu
Renato D. Lopes, MD, PhD, Principal Investigator
D'Or Institute for Research and Education