COVID-19 and ACE -inhibitors and angiotensin receptor blockers-: The need to differentiate between early infection and acute lung injury

González-Rayas, José Manuel; Rayas-Gómez, Ana Lilia; García-González, José Juan; González-Yáñez, José Manuel; Hernández-Hernández, José Ascención; López-Sánchez, R.

doi:10.1016/j.rccar.2020.04.005

Cited by 10 publications

(9 citation statements)

References 21 publications

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“… 144 There has been initial concern about the safety of angiotensin-converting-enzyme inhibitors (ACE inhibitors) and angiotensin II receptor blockers (ARBs), related to the intensification of ACE2 receptor expression, which could be associated with an increased risk of SARS-CoV-2 infection. 145 However, ACE2 receptors may protect against acute respiratory distress syndrome (ARDS) in COVID-19 patients 145 and more recent studies suggest that the use of renin-angiotensin-aldosterone system inhibitors is not associated with increased risk of severe forms of COVID-19. 146 , 147 …”

Section: Discussionmentioning

confidence: 99%

A Physician's Guide for Workers’ Return to Work During COVID-19 Pandemic

Baptista

Burton

Pawlecki

et al. 2020

Journal of Occupational &Amp; Environmental Medicine

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Objective: Higher probability of developing severe COVID-19 has been associated with health risk factors and medical conditions which are common among workers globally. For at risk workers, return to work may require additional protective policies and procedures. Methods: A review of the medical literature was conducted on health risk factors and medical conditions associated with increased COVID-19 morbidity and mortality, standardized measures for community COVID transmission, and occupation-specific risk. Results: The relative risk of acquiring and the severity of COVID-19 for workers is associated with three pillars: individual risk, workplace risk, and community risk. Matrices were developed to determine a worker's individual risk based on these three pillars. Conclusions: A practical decision tool is proposed for physicians evaluating and managing individual worker COVID-19 risk in the context of returning to work.

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Section: Discussionmentioning

confidence: 99%

A Physician's Guide for Workers’ Return to Work During COVID-19 Pandemic

Baptista

Burton

Pawlecki

et al. 2020

Journal of Occupational &Amp; Environmental Medicine

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“…Conversely, the increase in the ACE2 receptor expression could be associated with a reduction of the severity of Acute Respiratory Distress Syndrome (ARDS) [32]. In this regard, ACE2 metabolizes the vasoconstrictor peptide angiotensin II to produce angiotensin 1-7, which is involved in reducing inflammation, tissue damage, and pulmonary edema [33]. Ongoing clinical studies would provide information on the effectiveness of ATV in preventing or mitigating these effects in patients with COVID-19 [34, 35].…”

Section: Discussionmentioning

confidence: 99%

Atorvastatin effectively inhibits late replicative cycle steps of SARS-CoV-2in vitro

Flórez-Álvarez

Zapata

et al. 2021

Preprint

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Introduction: SARS-CoV-2 has caused a pandemic of historic proportions and continues to spread worldwide. Currently, there is no effective therapy against this virus. This article evaluated the in vitro antiviral effect of Atorvastatin against SARS-CoV-2 and also identified the interaction affinity between Atorvastatin and three SARS-CoV-2 proteins, using in silico structure-based molecular docking approach. Materials and methods: The antiviral activity of Atorvastatin against SARS-CoV-2 was evaluated by three different treatment strategies using a clinical isolate of SARS-CoV-2. The interaction of Atorvastatin with Spike, RNA-dependent RNA polymerase (RdRp) and 3C-like protease (3CLpro) was evaluated by molecular docking. Results: Atorvastatin showed anti-SARS-CoV-2 activity of 79%, 54.8%, 22.6% and 25% at 31.2, 15.6, 7.9, and 3.9 µM, respectively, by pre-post-treatment strategy. In addition, atorvastatin demonstrated an antiviral effect of 26.9% at 31.2 µM by pre-infection treatment. This compound also inhibited SARS-CoV-2 in 66.9%, 75%, 27.9% and 29.2% at concentrations of 31.2, 15.6, 7.9, and 3.9 µM, respectively, by post-infection treatment. The interaction of atorvastatin with SARS-CoV-2 Spike, RdRp and 3CL protease yielded a binding affinity of -8.5 Kcal/mol, -6.2 Kcal/mol, and -7.5 Kcal/mol, respectively. Conclusion: Our study demonstrated the in vitro anti-SARS-CoV-2 activity of Atorvastatin, mainly against the late steps of the viral replicative cycle. A favorable binding affinity with viral proteins by bioinformatics methods was also shown. Due to its low cost, availability, well-established safety and tolerability, and the extensive clinical experience of atorvastatin, it could prove valuable in reducing morbidity and mortality from COVID-19.

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“…Although downregulation in ACE 2 with COVID-19 is reported in many studies and was previously confirmed in 2002 with SARS-CoV as well [ 10 ] yet, it is questionable by other studies that states that ACE 2 are still functioning despite being attached to the S protein of SARS-CoV-2, questioning the role of RAS dysregulated mechanism in stroke and COVID-19 [ 11 ] and that cytokine surge secondary to the virus infection may over express ACE 2 rather than down regulate it and this facilitates more viral entry to cells [ 12 ].…”

Section: Main Textmentioning

confidence: 99%

A review on SARS-CoV-2 and stroke pathogenesis and outcome

Roushdy

Hamid

2021

Egypt J Neurol Psychiatry Neurosurg

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Severe acute respiratory syndrome corona virus 2 hit strongly and hardly the entire globe for more than 1 year with a morbidity exceeding 139 million and a mortality approaching 3 million worldwide since its emergence in China in December 2019 until April 2021.Although being termed after its ancestor the acute respiratory syndrome corona virus that emerged in 2002. Yet, the current corona virus has its unique devastating presentations being pulmonary and extra pulmonary.In the current review, a highlight on the role played by corona virus 2 on pathogenesis and outcome of stroke is presented with an attempt to point to the most approved ways through which the corona virus induce stroke being disturbance in renin angiotensin system and angiotensin-converting enzyme 2 receptors downregulation, endothelial cell damage with coagulopathy, cytokine storm, and platelet as well as outcome and risks in patients who are suffering stroke with modifiable vascular risk factors and catching the severe acute respiratory syndrome corona virus 2.

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COVID-19 and ACE -inhibitors and angiotensin receptor blockers-: The need to differentiate between early infection and acute lung injury

Cited by 10 publications

References 21 publications

A Physician's Guide for Workers’ Return to Work During COVID-19 Pandemic

A Physician's Guide for Workers’ Return to Work During COVID-19 Pandemic

Atorvastatin effectively inhibits late replicative cycle steps of SARS-CoV-2in vitro

A review on SARS-CoV-2 and stroke pathogenesis and outcome

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