Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

[News] WARNING - COVID-19 RISK FACTORS
#1
Angry 
WARNING - COVID-19 RISK FACTORS
It appears that there is a HYPOTHESIS concerning RISK factors for COVID-19 which may affect many hose-heads in the community. 

It appears in the British Medical Journal "Lancet' and is not a proven fact. However, since it concerns common drugs like ACE inhibitors and common analgesics, it is worth considering when speaking to your doctor. It may prove to be nothing, but then again, forewarned is forearmed. DO NOT DISCONTINUE TAKING YOUR MEDS WITHOUT FIRST SPEAKING TO YOUR DOCTOR.

Quote:Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? (Published:March 11, 2020DOI:https://doi.org/10.1016/S2213-2600(20)30116-8

The most distinctive comorbidities of 32 non-survivors from a group of 52 intensive care unit patients with novel coronavirus disease 2019 (COVID-19) in the study by Xiaobo Yang and colleagues1 were cerebrovascular diseases (22%) and diabetes (22%). Another study2 included 1099 patients with confirmed COVID-19, of whom 173 had severe disease with comorbidities of hypertension (23·7%), diabetes mellitus (16·2%), coronary heart diseases (5·8%), and cerebrovascular disease (2·3%). In a third study,3 of 140 patients who were admitted to hospital with COVID-19, 30% had hypertension and 12% had diabetes. Notably, the most frequent comorbidities reported in these three studies of patients with COVID-19 are often treated with angiotensin-converting enzyme (ACE) inhibitors; however, treatment was not assessed in either study.

Human pathogenic coronaviruses (severe acute respiratory syndrome coronavirus [SARS-CoV] and SARS-CoV-2) bind to their target cells through angiotensin-converting enzyme 2 (ACE2), which is expressed by epithelial cells of the lung, intestine, kidney, and blood vessels.4 The expression of ACE2 is substantially increased in patients with type 1 or type 2 diabetes, who are treated with ACE inhibitors and angiotensin II type-I receptor blockers (ARBs).4 Hypertension is also treated with ACE inhibitors and ARBs, which results in an upregulation of ACE2.5 ACE2 can also be increased by thiazolidinediones and ibuprofen. These data suggest that ACE2 expression is increased in diabetes and treatment with ACE inhibitors and ARBs increases ACE2 expression. Consequently, the increased expression of ACE2 would facilitate infection with COVID-19. We therefore hypothesise that diabetes and hypertension treatment with ACE2-stimulating drugs increases the risk of developing severe and fatal COVID-19.

If this hypothesis were to be confirmed, it could lead to a conflict regarding treatment because ACE2 reduces inflammation and has been suggested as a potential new therapy for inflammatory lung diseases, cancer, diabetes, and hypertension. A further aspect that should be investigated is the genetic predisposition for an increased risk of SARS-CoV-2 infection, which might be due to ACE2 polymorphisms that have been linked to diabetes mellitus, cerebral stroke, and hypertension, specifically in Asian populations. Summarising this information, the sensitivity of an individual might result from a combination of both therapy and ACE2 polymorphism.

We suggest that patients with cardiac diseases, hypertension, or diabetes, who are treated with ACE2-increasing drugs, are at higher risk for severe COVID-19 infection and, therefore, should be monitored for ACE2-modulating medications, such as ACE inhibitors or ARBs. Based on a PubMed search on Feb 28, 2020, we did not find any evidence to suggest that antihypertensive calcium channel blockers increased ACE2 expression or activity, therefore these could be a suitable alternative treatment in these patients. 
 

This could be highly suspect and sensationally amplified in the mainstream news media to attract an audience. Here is another warning against taking action. Some media sources are cautioning against using ibuprofen drugs such as Advil and using Tylenol. 
Quote:Position Statement of the ESC Council on Hypertension on ACE-Inhibitors and Angiotensin Receptor Blockers

13 Mar 2020
Based on initial reports from China, and subsequent evidence that arterial hypertension may be associated with increased risk of mortality in hospitalized COVID-19 infected subjects, hypotheses have been put forward to suggest a potential adverse effects of angiotensin converting enzyme inhibitors (ACE-i) or Angiotensin Receptor Blockers (ARBs). It has been suggested, especially on social media sites, that these commonly used drugs may increase both the risk of infection and the severity of SARS-CoV2. The concern arises from the observation that, similar to the coronavirus causing SARS, the COVID-19 virus binds to a specific enzyme called ACE2 to infect cells, and ACE2 levels are increased following treatment with ACE-i and ARBs. 

Because of the social media-related amplification, patients taking these drugs for their high blood pressure and their doctors have become increasingly concerned, and, in some cases, have stopped taking their ACE-I or ARB medications.

This speculation about the safety of ACE-i or ARB treatment in relation to COVID-19 does not have a sound scientific basis or evidence to support it. Indeed, there is evidence from studies in animals suggesting that these medications might be rather protective against serious lung complications in patients with COVID-19 infection, but to date there is no data in humans.

The Council on Hypertension of the European Society of Cardiology wish to highlight the lack of any evidence supporting harmful effect of ACE-I and ARB in the context of the pandemic COVID-19 outbreak.

The Council on Hypertension strongly recommend that physicians and patients should continue treatment with their usual anti-hypertensive therapy because there is no clinical or scientific evidence to suggest that treatment with ACEi or ARBs should be discontinued because of the Covid-19 infection.

BE CAREFUL WHAT YOU READ AND CHECK WITH YOUR PHYSICIAN BEFORE TAKING PRECIPITOUS ACTION.
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
Post Reply Post Reply






Donate to Apnea Board  
#2
RE: WARNING - COVID-19 RISK FACTORS
Thanks for posting. I had my 6 month follow-up with my PCP yesterday, since I've got a big buffet of various afflictions including COPD and complex apnea. I was recently referred out to a new cardiac doc, and that was a topic of discussion. Funny or not, we did not discuss any extra precautions or modifying medications due to Corona.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply


Possibly Related Threads...
Thread Author Replies Views Last Post
  Disinfecting your FOOD [COVID-19] SuperSleeper 1 52 03-30-2020, 12:39 AM
Last Post: Melman
  Covid 19 how it kills video. Cpapian 1 59 03-29-2020, 04:06 PM
Last Post: SuperSleeper
Angry [COVID-19] CORONAVIRUS (N-COVID-19) srlevine1 20 999 03-08-2020, 06:17 PM
Last Post: srlevine1
  [Health] CORONAVIRUS & Sleep [Tracking the COVID-19, Wuhan Virus] SuperSleeper 8 715 02-17-2020, 08:10 PM
Last Post: SuperSleeper
  Heads-Up! Major Online Ad Fraud Operation Warning Crimson Nape 1 450 11-28-2018, 03:17 PM
Last Post: Melman
Grin [Health] Regular chocolate consumption may be linked to lower risk of heart flutter DeepBreathing 10 1,853 11-08-2017, 01:30 PM
Last Post: FunkOdyssey
  Do statins really reduce your risk of heart disease? zonk 37 10,586 06-16-2015, 10:56 AM
Last Post: Mark Douglas


New Posts   Today's Posts






About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.