Renin-angiotensin system inhibitors improve the clinical outcomes of COVID-19 patients with hypertension
Open accessAbstract
The dysfunction of the renin-angiotensin system (RAS) has been observed in coronavirus infection disease (COVID-19) patients, but whether RAS inhibitors, such as angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II type 1 receptor blockers (ARBs), are associated with clinical outcomes remains unknown. COVID-19 patients with hypertension were enrolled to evaluate the effect of RAS inhibitors. We observed that patients receiving ACEI or ARB therapy had a lower rate of severe diseases and a trend toward a lower level of IL-6 in peripheral blood. In addition, ACEI or ARB therapy increased CD3 and CD8 T cell counts in peripheral blood and decreased the peak viral load compared to other antihypertensive drugs. This evidence supports the benefit of using ACEIs or ARBs to potentially contribute to the improvement of clinical outcomes of COVID-19 patients with hypertension.
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AngII-AT1R axis inhibitors may be beneficial for COVID-19 patients to decrease serum IL-6 levels.
“Consistent with animal models, it was reported that AngII–AT1R axis inhibitors may be beneficial for COVID-19 patients (360–363) to decrease serum IL-6 levels (360).”
From IL-6 in inflammation, autoimmunity and cancer (2021) · cites this paper as [360]
The Results report a trend toward lower peripheral-blood IL-6 in the ACEI/ARB group, and the Discussion suggests these drugs may attenuate inflammation through IL-6 inhibition. The study enrolled COVID-19 patients with hypertension; it does not establish an IL-6 decrease in COVID-19 patients generally, and the reported IL-6 finding was a trend rather than a confirmed reduction. (LLM, conf=0.86)
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- Authors
- Meng, J., Xiao, G., Zhang, J., He, X., Ou, M., Bi, J., Yang, R., Di, W., Wang, Z., Li, Z., Gao, H., Liu, L., & Zhang, G.
- Affiliations
- Southern University of Science and Technology (CN)
- Shenzhen Bay Laboratory (CN)
- Corresponding author
- Gao, Hong
- Liu, Lei
- Zhang, Guoliang
- ORCID
- Venue
- Emerging Microbes & Infections
- Publisher
- Informa UK Limited
- Published
- 2020-01
- Volume
- 9
- Issue
- 1
- Pages
- 757-760
- ISSN
- 2222-1751 (ISSN-L)
- PMC
- PMC7170368
- OpenAlex
- W3013871850
- Cited by
- 619
- References
- 14
- Citations by year
- 2026: 3 · 2025: 9 · 2024: 22 · 2023: 31 · 2022: 61 · 2021: 194 · 2020: 297 · 2018: 1
- FWCI
- 19.12
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Emerging Microbes & Infections (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Informationszentrum Lebenswissenschaften (ZB MED) (submittedVersion, cc-by)
- ImmPort
- Funders
- National Natural Science Foundation of China (81873958)
- Topics
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Keywords
- COVID-19 pandemic, hypertension, renin-angiotensin system, ACE inhibitors, angiotensin receptor blockers, SARS-CoV-2, interleukin-6, T-cell count, viral load, antihypertensive therapy
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, COVID-19 Drug Treatment, Aged, Angiotensin-Converting Enzyme Inhibitors, Antihypertensive Agents, C-Reactive Protein, China, Female, Humans, Hypertension, Male, Middle Aged, Pneumonia, Viral, Renin-Angiotensin System, Retrospective Studies, Interleukin-6, Treatment Outcome, CD3 Complex, Coronavirus Infections, CD8-Positive T-Lymphocytes, Viral Load, Angiotensin II Type 1 Receptor Blockers, Pandemics
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