U.S. scientists have found a possible explanation for the serious lung complications observed in some people diagnosed with COVID-19, highlighting the role of recommended drugs for patients with heart attack, hypertension, diabetes and chronic kidney disease.
In a study published in Journal of Travel Medicine, researchers note that beta-coronavirus SARS, such as the new SARS-CoV-2, which causes COVID-19, binds to angiotensin converting enzyme 2 (ACE2) receptors in the lower respiratory tract of infected patients for gain entry into the lungs. Viral pneumonia and potentially fatal respiratory failure can cause sensitive people after 10-14 days, they said.
“Angiotensin converting enzyme (ACEI) inhibitors and angiotensin receptor blockers (ARB) are highly recommended drugs for patients with cardiovascular disease including heart attacks, hypertension, diabetes and chronic kidney disease to name a few. “said James Diaz, a professor at Louisiana State University (LSU) in the United States. “Many of those who develop these diseases are older adults. They are prescribed these drugs and take them every day, “said Diaz.
Research on experimental models showed an increase in the number of ACE2 receptors in the bloodstream between the heart and lungs after ACE inhibitors have been injected into the veins, the scientists explained. “Since patients treated with ACEI and ARBS will have more ACE2 receptors in their lungs to which coronavirus S proteins bind, they may be at increased risk of serious disease outcomes due to SARS-CoV-2 infections. “said Diaz.
This hypothesis, he said, is supported by a recent analysis of 1,099 laboratory-confirmed COVID-19 infections treated in China during the reporting period, from 11 December 2019 to 29 January 2020. This study reported more serious pathological outcomes in patients with hypertension, coronary artery disease, diabetes and chronic kidney disease. All diagnosed patients met recommended indications for treatment with ACEI or ARB, according to the researchers.
Diaz said two mechanisms can protect children from COVID-19 infections: cross-protective antibodies from multiple upper respiratory tract infections caused by the common cold-causing alpha coronaviruses and fewer ACE2 receptors in their lower respiratory tracts to attract S-binding proteins of beta-coronaviruses.
It recommends future case-control studies in patients with COVID-19 infections to further confirm that chronic ACEI or ARB therapy may increase the risk of serious outcomes. “Patients treated with ACEI and ARB for cardiovascular disease should not stop taking their medicines, but should avoid crowds, mass events, ocean cruises, prolonged air travel and all people with respiratory diseases during the current COVID epidemic- 19 in order to reduce their risk of infection, “he added.