Iheanacho Chinonyerem O, Odili Valentine U, Eze Uchenna I H
Department of Clinical Pharmacy and Public Health, Faculty of Pharmacy, University of Calabar, Calabar, Nigeria.
Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, niversity of Benin, Benin City, Nigeria.
Futur J Pharm Sci. 2021;7(1):73. doi: 10.1186/s43094-021-00224-4. Epub 2021 Mar 24.
Angiotensin-converting-enzyme-2, being the receptor for SARS-CoV-2, is increased in the use of RAAS inhibitors. Therefore, concerns have been raised over risks of SARS-CoV-2 infection and poor prognosis of COVID-19 in persons with prior exposure to these drugs. This study aimed to systematically review available evidence for associations between exposure to RAAS inhibitors with susceptibility to SARS-CoV-2 infection and clinical outcomes in infected persons. It hopes to address the question on the effects of RAAS inhibitors on the risk of COVID-19 and its prognosis.
Search was conducted in the databases of PubMed, Scopus, Cochrane, Embase and MedRxiv.org from December 2019 to May 31, 2020, using relevant keywords. Additional articles were identified through hand-searching of reference lists. Studies that reported associations between positive tests to COVID-19 and use of RAAS inhibitors, and treatment outcomes of COVID-19 patients who had exposure to RAAS inhibitors were considered eligible. The Newcastle-Ottawa scale was used to assess risk of bias in individual studies. The review was conducted in line with Preferred Regulatory Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines 2009. From the 952 studies screened and 2 studies from reference hand-searching, 18 were reviewed. Four studies evaluated the risks for SARS-CoV-2 infection among RAAS inhibitors users, and 16 (including 2 of the 4 studies) evaluated the clinical outcomes associated with previous exposure to RAAS inhibitors.
Evidence does not suggest higher risks for SARS-CoV-2 infection or poor disease prognosis in the use of RAAS inhibitors. This suggests the continued use of RAAS inhibitors by patients with existing needs, which supports the position statements of American Heart Association and European societies for Cardiology.
The online version contains supplementary material available at 10.1186/s43094-021-00224-4.
血管紧张素转换酶2作为严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的受体，在使用肾素-血管紧张素-醛固酮系统（RAAS）抑制剂时会增加。因此，人们对既往接触过这些药物的人感染SARS-CoV-2的风险以及新型冠状病毒肺炎（COVID-19）预后不良表示担忧。本研究旨在系统评价接触RAAS抑制剂与SARS-CoV-2感染易感性及感染者临床结局之间关联的现有证据。它希望解决RAAS抑制剂对COVID-19风险及其预后影响的问题。
于2019年12月至2020年5月31日在PubMed、Scopus、Cochrane、Embase和MedRxiv.org数据库中进行检索，使用相关关键词。通过手工检索参考文献列表确定其他文章。报告COVID-19检测阳性与RAAS抑制剂使用之间关联以及接触过RAAS抑制剂的COVID-19患者治疗结局的研究被视为合格。采用纽卡斯尔-渥太华量表评估个体研究中的偏倚风险。本综述按照2009年系统评价和Meta分析的首选报告项目（PRISMA）指南进行。从筛选的952项研究和参考文献手工检索得到的2项研究中，共纳入18项进行综述。4项研究评估了RAAS抑制剂使用者感染SARS-CoV-2的风险，16项研究（包括4项研究中的2项）评估了既往接触RAAS抑制剂相关的临床结局。
证据并不表明使用RAAS抑制剂会增加SARS-CoV-2感染风险或导致疾病预后不良。这表明有现有需求的患者可继续使用RAAS抑制剂，这支持了美国心脏协会和欧洲心脏病学会的立场声明。
在线版本包含可在10.https://doi.org/10.1186/s43094-021-00224-4获取的补充材料。
