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AuthorAkhtar, S.
AuthorBenter, I.F.
AuthorDanjuma, M.I.
AuthorDoi, S.A.R.
AuthorHasan, S.S.
AuthorHabib, A.M.
Available date2022-04-18T08:10:55Z
Publication Date2020
Publication NameJournal of Drug Targeting
ResourceScopus
Identifierhttp://dx.doi.org/10.1080/1061186X.2020.1797754
URIhttp://hdl.handle.net/10576/29974
AbstractThe COVID-19 pandemic is caused by the severe acute-respiratory-syndrome-coronavirus-2 that uses ACE2 as its receptor. Drugs that raise serum/tissue ACE2 levels include ACE inhibitors (ACEIs) and angiotensin-II receptor blockers (ARBs) that are commonly used in patients with hypertension, cardiovascular disease and/or diabetes. These comorbidities have adverse outcomes in COVID-19 patients that might result from pharmacotherapy. Increasing ACE2 could potentially increase the risk of infection, severity or mortality in COVID-19 or it might be protective as it forms angiotensin-(1?7) which exhibits anti-inflammatory/anti-oxidative effects and prevents diabetes- and/or hypertension-induced end-organ damage. Thus, there existed clinical uncertainty. Here, we review studies implicating 15 classes of drugs in increasing ACE2 levels in vivo and the available literature on the clinical safety of these drugs in COVID-19 patients. Further, in a re-analysis of clinical data from a meta-analysis of 9 studies, we show that ACEIs/ARBs usage was not associated with an increased risk of all-cause mortality. Literature suggests that ACEIs/ARBs usage generally appears to be clinically safe though their use in severe COVID-19 patients might increase the risk of acute renal injury. For definitive clarity, further clinical and mechanistic studies are needed in assessing the safety of all classes of ACE2 raising medications.
SponsorThis work was funded by a QNRF Rapid Response call grant on COVID-19 [RRC-2-047] to SA, MD and AH. Open Access funding was provided by the Qatar National Library.
Languageen
PublisherTaylor and Francis Ltd
Subjectangiotensin converting enzyme 2
angiotensin receptor antagonist
dipeptidyl carboxypeptidase inhibitor
angiotensin converting enzyme 2
angiotensin receptor antagonist
dipeptidyl carboxypeptidase
dipeptidyl carboxypeptidase inhibitor
coronavirus disease 2019
disease severity
drug approval
drug safety
drug use
hospitalization
human
human cell
in vivo study
infection risk
mortality risk
nonhuman
pandemic
pharmaceutical care
priority journal
renin angiotensin aldosterone system
Review
Severe acute respiratory syndrome coronavirus 2
animal
Betacoronavirus
cardiovascular disease
complication
Coronavirus infection
diabetes mellitus
drug effect
isolation and purification
metabolism
mortality
pathophysiology
risk factor
virus pneumonia
Angiotensin Receptor Antagonists
Angiotensin-Converting Enzyme Inhibitors
Animals
Betacoronavirus
Cardiovascular Diseases
Coronavirus Infections
Diabetes Mellitus
Humans
Pandemics
Peptidyl-Dipeptidase A
Pneumonia, Viral
Risk Factors
TitlePharmacotherapy in COVID-19 patients: a review of ACE2-raising drugs and their clinical safety
TypeArticle Review
Pagination683-699
Issue Number8-Jul
Volume Number28
dc.accessType Abstract Only


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