Department of Radiology, MD Radiology Associate Professor Istanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine.
Department of Pulmonary Medicine, MD Pulmonary Medicine Specialist Haydarpaşa Sultan Abdülhamidhan Training and Research Hospital, Turkey.
Clin Exp Hypertens. 2021 May 19;43(4):341-348. doi: 10.1080/10641963.2021.1883051. Epub 2021 Feb 13.
There is not enough data on the effect of angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs) on lung involvement in patients with COVID-19 pneumonia and hypertension (HT). Our aim was to compare the lung involvement of the HT patients hospitalized for COVID-19 using ACEIs/ARBs with the patients taking other anti-HT medications.
: Patients who have a diagnosis of HT among the patients treated for laboratory-confirmed COVID-19 between 31 March 2020 and 28 May 2020 were included in the study. One hundred and twenty-four patients were divided into two as ACEIs/ARBs group (n = 75) and non-ACEIs/ARBs group (n = 49) according to the anti-HT drug used. The chest CT involvement areas of these two groups were evaluated quantitatively by two observers including all lobes, and total severity score (TSS) was calculated. These TSS values were compared between drug groups and clinical groups.
In clinical classification; there were 4 (%3.2) asymptomatic, 5 (4.0%) mild type, 92 (74.1%) common type, 14 (11.3%) severe type, 9 (7.3%) critical type patients. ACEI/ARB group's TSS (mean±SD, 7.74 ± 3.54) was statistically higher than other anti-HT medication group (mean±SD, 4.40 ± 1.89) ( < .001). Likewise, severe-critical clinical type's TSS (mean±SD, 9.17 ± 3.44) was statistically higher than common type (mean±SD, 5.76 ± 3.07) ( < .001). Excellent agreement was established between the two blinded observers in the TSS measurements.
Quantitative evaluation of CT and TSS score can give an idea about the clinical classification of the patient. TSS is higher in ACEI/ARB group than non-ACEIs/ARBs group.
关于血管紧张素转换酶抑制剂（ACEI）/血管紧张素受体阻滞剂（ARB）对 COVID-19 肺炎合并高血压（HT）患者肺部受累的影响，目前数据不足。我们的目的是比较使用 ACEI/ARB 和其他抗 HT 药物治疗的 COVID-19 住院 HT 患者的肺部受累情况。
本研究纳入了 2020 年 3 月 31 日至 2020 年 5 月 28 日期间确诊为 COVID-19 并接受治疗的 HT 患者。根据使用的抗 HT 药物，将 124 例患者分为 ACEI/ARB 组（n=75）和非 ACEI/ARB 组（n=49）。两名观察者对两组患者的所有肺叶进行定量评估，并计算总严重程度评分（TSS）。比较两组药物和临床组之间的 TSS 值。
在临床分类中，无症状患者 4 例（3.2%），轻症患者 5 例（4.0%），普通型患者 92 例（74.1%），重症患者 14 例（11.3%），危重症患者 9 例（7.3%）。ACEI/ARB 组的 TSS（均数±标准差，7.74±3.54）明显高于其他抗 HT 药物组（均数±标准差，4.40±1.89）（<.001）。同样，重症-危重症临床类型的 TSS（均数±标准差，9.17±3.44）明显高于普通型（均数±标准差，5.76±3.07）（<.001）。两名观察者在 TSS 测量方面具有极好的一致性。
CT 定量评估和 TSS 评分可提供患者临床分类的信息。ACEI/ARB 组的 TSS 高于非 ACEI/ARB 组。
