Infectious Disease

Renin Angiotensin Inhibitors Protected in Sufferers Hospitalized with COVID-19: REPLACE COVID

January 08, 2021

2 min read

Source / information

Disclosure:
Cohen reports that she has received consulting fees from Bayer, Bristol Myers Squibb, Edwards Lifesciences, Johnson & Johnson and Sanifit; Research grants from Bristol Myers Squibb, Fukuda Denshi, Microsoft, and the NIH; Compensation from the AHA and the American College of Cardiology; and honoraria from the University of Utah and Washington University. Chirinos does not report any relevant financial information. In the study you will find all relevant financial information from all other authors.

ADD SUBJECT TO EMAIL ALARMS

Receive an email when new articles are published

Please enter your email address to receive an email when new articles are published . “data-action =” subscribe “> subscribe

We could not process your request. Please try again later. If you continue to have this problem, please contact customerservice@slackinc.com.

Back to Healio

According to researchers, it is safe for patients hospitalized with COVID-19 to continue using inhibitors of the renin-angiotensin system.

The REPLACE COVID study published in The Lancet Respiratory Medicine is in line with the results of the BRACE-CORONA study, in which, as Healio previously reported, suspending ACE inhibitors or angiotensin receptor blockers in patients on mild or mild treatment had no benefit moderate COVID-19.

COVID-19

Source: Adobe Stock

According to researchers, REPLACE COVID was launched after several research and press articles were circulated at the start of the COVID-19 pandemic, referring to these drugs, which may upregulate virus receptors, raising safety concerns about their use this medication resulted in patients with COVID-19.

Jordana B. Cohen

“Given that more than 40 million people in the US are prescribed these drugs, we felt it was crucial to have high quality, randomized trial results to educate ourselves about the safety of continued use of these drugs in patients who are on Get sick with COVID. 19, ” Jordana B. Cohen, MD, Assistant professor from the Kidney Electrolyte and Hypertension Division and Biostatistics, Epidemiology, and Computer Science Division at the University of Pennsylvania’s Perelman School of Medicine, Healio said. “Our study, along with other available evidence, shows that it is safe to continue these drugs in hospital in COVID-19 patients who need them for a variety of reasons.”

The researchers conducted the prospective, randomized, open-label study, which was conducted from March 31 to August 20 in 20 major referral hospitals in seven countries. The study enrolled 152 participants (mean age 62 years; 45% women) 18 years and older who were hospitalized with COVID-19 who received a renin angiotensin system inhibitor prior to admission. Participants were randomly assigned to continuation of their renin-angiotensin system inhibitor (n = 75) or to discontinuation (n = 77).

The primary result was a global ranking of the participants, which were distributed over four hierarchical levels, such as time to death, duration of mechanical ventilation, time for kidney replacement or vasopressor therapy, and multi-organ dysfunction during the hospital stay.

The continuation of the inhibitors of the renin-angiotensin system had no effect on the global ranking value compared to withdrawal (mean rank 73 for continuation versus 81 for withdrawal; beta coefficient = 8; 95% CI, -13 to 29; P = 0.61). . Intensive care or invasive mechanical ventilation was required for 21% of participants in the continuation group, compared with 18% in the dropout group (P = 0.61).

There were no differences between groups for length of hospital stay (P = .56), length of ICU stay / invasive ventilation time (P = .59), or the area under the curve of the death-adjusted score for the Assessment of sequential organ failure (P = 0.38).

In the continuation group, 15% of patients died compared with 13% in the dropout group (P = 0.99). At least one adverse event was reported by 39% of participants in the continuation group and 36% of participants in the dropout group (P = 0.77).

The researchers observed no difference in blood pressure, serum potassium, or creatinine in either group during follow-up.

According to a Penn Medicine press release, the results support the international society’s recommendations for continuation of ACE inhibitors and angiotensin receptor blockers in patients being hospitalized for COVID-19 unless a clear, alternative medical problem is identified with ongoing therapy.

Julio Chirinos

“We are awaiting the results of several ongoing studies to see whether reintroducing these drugs can actually help to treat COVID-19.” Julio Chirinos, MD, Healio said an associate professor of medicine in the Department of Cardiovascular Medicine at the University of Pennsylvania Hospital and the Perelman School of Medicine at the University of Pennsylvania. “Future research may also be helpful in determining whether there is a difference between ACE inhibitors and angiotensin receptor blockers in setting up COVID-19 that our study failed to address.”

For more informations:

Julio Chirinos, MD, can be reached at julio.chirinos@uphs.upenn.edu; Twitter: @juliochirinosmd.

Jordana B. Cohen, MD, can be reached at jco@pennmedicine.upenn.edu; Twitter: @jordy_bc.

ADD SUBJECT TO EMAIL ALARMS

Receive an email when new articles are published

Please enter your email address to receive an email when new articles are published . “data-action =” subscribe “> subscribe

We could not process your request. Please try again later. If you continue to have this problem, please contact customerservice@slackinc.com.

Back to Healio

COVID-19 Resource Center

COVID-19 Resource Center

Related Articles