Debbie Rigby rounds up the latest in research news
Based on currently available data and in view of the overwhelming evidence of mortality reduction in cardiovascular disease, ACE-I and ARB therapy should be maintained or initiated in patients with heart failure, hypertension, or myocardial infarction according to current guidelines as tolerated, irrespective of SARS-CoV2. Withdrawal of RAAS inhibition or preemptive switch to alternate drugs at this point seems not advisable, since it might even increase cardiovascular mortality in critically ill COVID-19 patients.
European Heart Journal, ehaa235.
There is an association between increased mortality and morbidity of COVID-19 in patients with hypertension. It remains unclear whether this association to due to hypertension or medicines used to treat hypertension. There has been a suggestion that ACEIs and ARBs affect the severity and mortality of COVID-19. However, there is insufficient clinical or scientific evidence to determine how to appropriately manage hypertension in the setting of COVID-19.
JAMA. Published online March 24, 2020.
In this cohort study involving 201 patients with confirmed COVID-19 pneumonia, risk factors associated with the development of acute respiratory distress syndrome (ARDS) and progression from ARDS to death included older age, neutrophilia, and organ and coagulation dysfunction. Treatment with methylprednisolone may be beneficial for patients who develop ARDS.
JAMA Intern Med. Published online March 13, 2020.
In this retrospective, multicentre cohort study of patients with laboratory-confirmed COVID-19 death was associated with older age. Median duration of viral shedding was 20 days in survivors, but SARS-CoV-2 was detectable until death in non-survivors. The longest observed duration of viral shedding in survivors was 37 days.
Lancet, published 11 March, 2020.