血管紧张素转化酶抑制剂（ACEI）或血管紧张素受体阻滞剂（ARB）可能对 COVID-19 患者是安全的。
Angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARBs) may be safe for COVID-19 patients.
机构信息
The Department of Cardiovascular Surgery, Dalian Municipal Central Hospital, Dalian Medical University, Dalian, China.
Depart of Respiratory Medicine, Dalian Municipal Central Hospital, Dalian, China.
出版信息
BMC Infect Dis. 2021 Jan 25;21(1):114. doi: 10.1186/s12879-021-05821-5.
BACKGROUND
To investigate the effects of angiotensin-converting enzyme inhibitor (ACEI) and angiotensin receptor blockers (ARBs) administration to hypertension patients with the coronavirus disease 2019 (COVID-19) induced pneumonia.
METHODS
We recorded the recovery status of 67 inpatients with hypertension and COVID-19 induced pneumonia in the Raytheon Mountain Hospital in Wuhan during February 12, 2020 and March 30, 2020. Patients treated with ACEI or ARBs were categorized in group A (n = 22), while patients who were not administered either ACEI or ARBs were categorized into group B (n = 45). We did a comparative analysis of various parameters such as the pneumonia progression, length-of-stay in the hospital, and the level of alanine aminotransferase (ALT), serum creatinine (Cr), and creatine kinase (CK) between the day when these patients were admitted to the hospital and the day when the treatment ended.
RESULTS
These 67 hypertension cases counted for 33.17% of the total COVID-19 patients. There was no significant difference in the usage of drug treatment of COVID-19 between groups A and B (p > 0.05). During the treatment, 1 case in group A and 3 cases in group B progressed from mild pneumonia into severe pneumonia. Eventually, all patients were cured and discharged after treatment, and no recurrence of COVID-2019 induced pneumonia occurred after the discharge. The length of stays was shorter in group A as compared with group B, but there was no significant difference (p > 0.05). There was also no significant difference in other general parameters between the patients of the groups A and B on the day of admission to the hospital (p > 0.05). The ALT, CK, and Cr levels did not significantly differ between groups A and B on the day of admission and the day of discharge (p > 0.05).
CONCLUSIONS
To treat the hypertension patients with COVID-19 caused pneumonia, anti-hypertensive drugs (ACEs and ARBs) may be used according to the relative guidelines. The treatment regimen with these drugs does not need to be altered for the COVID-19 patients.
背景
探讨血管紧张素转换酶抑制剂（ACEI）和血管紧张素受体阻滞剂（ARB）在治疗伴有 2019 年冠状病毒病（COVID-19）引起的肺炎的高血压患者中的作用。
方法
我们记录了 2020 年 2 月 12 日至 2020 年 3 月 30 日期间武汉雷神山医院 67 例高血压合并 COVID-19 肺炎住院患者的康复情况。接受 ACEI 或 ARB 治疗的患者分为 A 组（n=22），未接受 ACEI 或 ARB 治疗的患者分为 B 组（n=45）。我们对两组患者从入院当天到治疗结束当天的肺炎进展、住院时间以及丙氨酸氨基转移酶（ALT）、血清肌酐（Cr）和肌酸激酶（CK）水平等各项参数进行了比较分析。
结果
这 67 例高血压病例占 COVID-19 患者总数的 33.17%。A 组和 B 组 COVID-19 药物治疗使用率无统计学差异（p＞0.05）。治疗过程中，A 组 1 例、B 组 3 例由轻症肺炎进展为重症肺炎。最终，所有患者经治疗后痊愈出院，出院后未再发生 COVID-19 肺炎复发。A 组的住院时间较 B 组短，但无统计学差异（p＞0.05）。两组患者入院当天的一般参数也无统计学差异（p＞0.05）。入院当天和出院当天，A 组和 B 组的 ALT、CK 和 Cr 水平无统计学差异（p＞0.05）。
结论
对于 COVID-19 合并肺炎的高血压患者，可根据相关指南使用抗高血压药物（ACE 抑制剂和 ARB）。对于 COVID-19 患者，无需改变这些药物的治疗方案。
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