Different Laboratory Abnormalities in COVID-19 Patients with Hypertension or Diabetes
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LETTER
Different Laboratory Abnormalities in COVID-19 Patients with Hypertension or Diabetes Xiaojun Wu1 • Tong Wang1 • Yilu Zhou2,3 • Xiaofan Liu4 • Hong Zhou4 • Yang Lu4 • Weijun Tan4 • Mingli Yuan4 • Xuhong Ding1 • Jinjing Zou1 • Ruiyun Li1 • Hailing Liu1 • Rob M. Ewing2,3 • Yi Hu4 Hanxiang Nie1 • Yihua Wang2,3,5
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Received: 9 July 2020 / Accepted: 31 August 2020 Ó Wuhan Institute of Virology, CAS 2020
Dear Editor, The pandemic of COVID-19, a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; previously known as 2019-nCoV), has placed an enormous burden on health authorities in 213 countries and territories. At the time of writing, over 26 million cases have been recorded across the world, with more than 870 k associated deaths (www.worldometers.info/coronavirus/). World Bank warns COVID-19 pandemic risks dramatic rise in poverty, with the majority of economies expecting to suffer from falling levels of GDP in 2020. The main symptoms of COVID-19 are onset of a new continuous cough and/or a high temperature with symptoms ranging from mild to life threatening. Those who are
Xiaojun Wu, Tong Wang, Yilu Zhou, Xiaofan Liu, Hong Zhou have contributed equally to this work. & Yihua Wang [email protected] & Hanxiang Nie [email protected] & Yi Hu [email protected] 1
Department of Respiratory and Critical Medicine, Renmin Hospital of Wuhan University, Wuhan 430060, China
2
Biological Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton SO17 1BJ, UK
3
Institute for Life Sciences, University of Southampton, Southampton SO17 1BJ, UK
4
Department of Pulmonary and Critical Care Medicine, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430014, China
5
NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton SO16 6YD, UK
elderly or have pre-existing health issues are more likely to develop severe disease. The most prevalent comorbidity is hypertension, followed by diabetes (Guan et al. 2020a, b). We reported recently that hypertension is a risk factor for severe cases of COVID-19, independent of age and other variables (Liu et al. 2020a). An important question is why patients with hypertension and diabetes yield poorer clinical outcomes than those without. Human pathogenic coronavirus SARS-CoV-2 utilizes angiotensin-converting enzyme 2 (ACE2) as a receptor for viral cell entry. Since the levels of ACE2 are substantially increased in patients with hypertension or diabetes, who are treated with ACE inhibitors (ACEIs) and angiotensin II type-I receptor blockers (ARBs) (Ferrario et al. 2005), Fang and colleagues hypothesized that ACE2-stimulating drugs could potentially increase the risk of developing severe COVID-19 (Fang et al. 2020). This was not supported by a recent study led by Dr. Reynolds (Reynolds et al. 2020), whose analysis showed no positive association for ACEIs or
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