Effect of angiotensin II blockers on the prognosis of COVID-19: a toxicological view
- PDF / 143,535 Bytes
- 2 Pages / 595.276 x 790.866 pts Page_size
- 53 Downloads / 193 Views
LETTER TO THE EDITOR
Effect of angiotensin II blockers on the prognosis of COVID-19: a toxicological view Farshad M. Shirazi 1 & Shireen Banerji 2 & Samaneh Nakhaee 3 & Omid Mehrpour 2,3 Received: 14 April 2020 / Accepted: 19 May 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Sir, At the time of writing this letter (March 25, 2020), COVID-19 is spreading around the world, and unfortunately, our information as to its mechanism of action, prognostic factors, and management is limited. However, it is assumed that using receptormediated endocytosis, SARS-CoV-2 enters pulmonary alveolar epithelial cells via its entry receptor, that is, the angiotensinconverting enzyme 2 (ACE2) [1]. The virus creates an essential binding to the membrane-bound form of ACE2 and causes an internalization of the complex by the host cell [2]. Clinical presentations of symptomatic COVID-19 patients consist of fever, cough, nasal congestion, fatigue, and other signs of respiratory tract infection, typically presenting within 1 week following exposure to the virus. In approximately 75% of COVID-19 patients, the infection leads to acute illness with dyspnea and severe pneumonia, as observed in computed tomography (CT) scan on admission [1]. Angiotensin II receptor (AT1R) blockers, like losartan, valsartan, or telmisartan, are widely used for the management of hypertension [3]. Clinical experience with these drugs has shown that they are well-tolerated with a favorable safety profile. Sommerstein (2020) documented ACE inhibitors as a potential risk factor for fatal COVID-19 [4]. Parsa et al. evaluated the potential of ACE inhibitors to cause toxicity in adults and children and found that these drugs are generally
* Omid Mehrpour [email protected] Farshad M. Shirazi [email protected] 1
Arizona Poison & Drug Information Center, University of Arizona, College of Pharmacy and University of Arizona College of Medicine, Tucson, AZ, USA
2
Denver Health/Rocky Mountain Poison and Drug Safety, Denver, CO, USA
3
Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran
safe. Also, they discovered that patients who ingested fivefold or a higher dose of these drugs might experience minor toxicity [3]. Therefore, from a toxicological perspective, this category of drugs is considered relatively safe. In this letter, we are raising a simple question: should we consider the use of angiotensin II receptor antagonists as an adjuvant treatment to manage hospitalized COVID-19 patients and patients experiencing respiratory symptoms clinically or by radiograph to halt the spread of the virus in healthy tissues? Sun et al. [5] and Phadke et al. [6] proposed that due to the dysregulation of the renin-angiotensin system by SARS-CoV2, these patients may benefit from the administration of AT2R blockers [3, 5]. They offered these suggestions based on the observation that ACE2 is the receptor-binding domain of SARS-CoV-2 spike protein [7]. Also, Vaduganathan (2020) highlighted the
Data Loading...
