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Angiotensin-Converting Enzyme inhibitors (ACE inhibitors) and Angiotensin II Receptor Blockers (ARBs) role in SARS-CoV-2 infection: A Rapid Systematic Review
| Content Provider | Research Square |
|---|---|
| Author | Oliveira, Haliton Alves De Matuoka, Jessica Yumi Parreira, Patrícia Do Carmo Silva Brito, Gabriela Vilela De Marra, Lays Pires Medeiros, Flávia Cordeiro De Avezum, Álvaro |
| Abstract | No medications specific treatments are known to be effective for COVID-19 until now. Several drug therapies are being used to optimize supportive care to relieve symptoms. Some observational and essentially theoretical studies have shared opposite opinions regarding the use of ACE inhibitors and ARBs in SARS-CoV-2 infected patients. Therefore, the aim of this review is to evaluate the relationship between ACE inhibitors and ARBs use and clinical effects in COVID-19 patients to guide clinicians for their medical early decision. Electronic searches were conducted on Embase, Medline via PubMed and ClinicalTrials.gov. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement was followed and adapted the research as a rapid review. Due to the emergency of the COVID-19 pandemic, any research in English, Portuguese or Spanish that discuss the mechanism of action, in vitro studies and those that draw conclusions based on observational or experimental studies were included. No studies were excluded based on the participant’s clinical or demographical characteristics. The risk of bias was assessed by one reviewer and checked by a second reviewer, using the Joanna Briggs Institute Checklist for Case Series. Any other mechanistic, theoretical or in vitro studies were evaluated as high risk of bias for clinical. Out of 64 studies retrieved, 17 were included in the review. Three studies suggest that both medications may increase the risk of worsening COVID-19, while three suggest they could be beneficial. Currently, there are seven ongoing trials on ARBs and ACE inhibitors. The available evidence does not allow us to draw definite conclusions on either harm or benefit of these medications in the presence of COVID-19. Discontinuing the therapy may be hasty and more robust evidence-based research is needed.No medications specific treatments are known to be effective for COVID-19 until now. Several drug therapies are being used to optimize supportive care to relieve symptoms. Some observational and essentially theoretical studies have shared opposite opinions regarding the use of ACE inhibitors and ARBs in SARS-CoV-2 infected patients. Therefore, the aim of this review is to evaluate the relationship between ACE inhibitors and ARBs use and clinical effects in COVID-19 patients to guide clinicians for their medical early decision. Electronic searches were conducted on Embase, Medline via PubMed and ClinicalTrials.gov. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement was followed and adapted the research as a rapid review. Due to the emergency of the COVID-19 pandemic, any research in English, Portuguese or Spanish that discuss the mechanism of action, in vitro studies and those that draw conclusions based on observational or experimental studies were included. No studies were excluded based on the participant’s clinical or demographical characteristics. The risk of bias was assessed by one reviewer and checked by a second reviewer, using the Joanna Briggs Institute Checklist for Case Series. Any other mechanistic, theoretical or in vitro studies were evaluated as high risk of bias for clinical. Out of 64 studies retrieved, 17 were included in the review. Three studies suggest that both medications may increase the risk of worsening COVID-19, while three suggest they could be beneficial. Currently, there are seven ongoing trials on ARBs and ACE inhibitors. The available evidence does not allow us to draw definite conclusions on either harm or benefit of these medications in the presence of COVID-19. Discontinuing the therapy may be hasty and more robust evidence-based research is needed. |
| Related Links | https://assets.researchsquare.com/files/rs-22273/v1/manuscript.pdf |
| File Format | HTM / HTML |
| DOI | 10.21203/rs.3.rs-22273/v1 |
| Language | English |
| Publisher Date | 2020-04-09 |
| Access Restriction | Open |
| Subject Keyword | COVID-19 SARS-CoV-2 Systematic review Angiotensin II Receptor Blockers Angiotensin-Converting Enzyme inhibitors |
| Content Type | Text |
| Resource Type | Article Preprint |
