Common Drugs that May Worsen Covid-19 Outcomes

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    As of Monday afternoon (March 23, 2020), the total number of confirmed COVID-19 cases is 372,563 with 16,381 deaths globally. 

    In the United States, the number of cases has increased to 41,708, with 573 deaths across all 50 states plus Washington, DC. 

    Worldwide, researchers are obviously working on understanding SARA-CoV2, the virus that causes the disease now known as COVID-19.

    Part of this understanding includes drugs that either interfere or contribute to recovery.

    Scientists now know that the SARS-CoV-2 virus binds to ACE2 receptors in the lower respiratory tracts to gain entry to the lungs.

    Since patients treated with ACE inhibitors and ARBs will have increased numbers of ACE2 receptors in their lungs for coronavirus S proteins to bind to, they may be at increased risk of severe disease outcomes due to SARS-CoV-2 infections.

    It should also be noted that ACE2 receptors express themselves in other parts of the body including the stomach, small intestine, lymph nodes, spleen and liver.

    But given the fact that heart disease is a leading cause of death, most people are taking ACE2 inhibitors and this poses a potential risk.

    ACE Inhibitors Might Increase the Risk of COVID-19

    People who are at risk of heart attacks, high blood pressure, diabetes or who have chronic disease are likely taking ACE2 inhibitors. 

    Research has shown an increase in the number of ACE2 receptors in the cardio(heart)-pulmonary(lungs) circulation after IV infusions of ACE inhibitors.

    Because the SARS-CoV2 virus S proteins bind to these receptors, it may pose a potential increased risk of severe disease outcomes due to infection.

    However, this doesn't mean that anyone currently taking an ACE2 inhibitor or Angiotensin Receptor Blocker (ARB) should stop taking their medication without first consulting their doctor.

    This hypothesis is supported by a recent descriptive analysis of 1,099 patients with laboratory-confirmed COVID-19 infections treated in China during the reporting period, December 11, 2019, to January 29, 2020. 

    Although this study reported more severe disease outcomes in patients with hypertension, coronary artery disease, diabetes, and chronic renal disease, it's only 1 study.

    More clinical studies need to be done before we can say for sure. 

    This means that patients currently being treated with ACE2 inhibitors and ARBs for cardiovascular diseases should not stop taking their medicine, but should avoid crowds, mass events, ocean cruises, prolonged air travel, and all persons with respiratory illnesses during the current COVID-19 outbreak in order to reduce their risks of infection.



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