Zhonghua Jie He He Hu Xi Za Zhi. 2020 Feb 16;43(0):E014. doi: 10.3760/cma.j.issn.1001-0939.2020.0014. [Epub ahead of print]
[Inhibitors of RAAS Might Be a Good Choice for the Therapy of COVID-19 Pneumonia].
[Article in Chinese; Abstract available in Chinese from the publisher]
Sun ML1, Yang JM2, Sun YP1, Su GH3.
Abstract
in English, Chinese
The novel coronavirus 2019 (COVID-19) infected patients by binding human ACE2, leading to severe pneumonia and highly mortality rate in patients. At present, there is no definite and effective treatment for COVID-19. ACE2 plays an important role in the RAAS, and the imbalance between ACE/Ang II/AT1R pathway and ACE2/Ang (1-7)/Mas receptor pathway in the RAAS system will lead to multi-system inflammation. Increased ACE and Ang II are poor prognostic factors for severe pneumonia. Animal studies have shown that RAAS inhibitors could effectively relieve symptoms of acute severe pneumonia and respiratory failure. The binding of COVID-19 and ACE2 resulted in the exhaustion of ACE2, and then ACE2/Ang (1-7)/Mas receptor pathway was inhibited. The balance of the RAS system was broken, and this would lead to the exacerbation of acute severe pneumonia. Therefore, we speculate that ACEI and AT1R inhibitors could be used in patients with COVID-19 pneumonia under the condition of controlling blood pressure, and might reduce the pulmonary inflammatory response and mortality.
PMID:
32061198
DOI:
10.3760/cma.j.issn.1001-0939.2020.0014
Personally.
I tell about ARB medicin (AT1R blocking medicin) Atacand: When I had to begin medicin against hypertension and also tendence to heart insufficience, I did use Atacand , because I did not tolerate ACEI or beta-blockers then, not even hydrochlorotiatzide. So I did notice that Atacand 4 mg had even ” diuretic”, anti-oedem effect and I had easier to breath, it was very good feeling to the lungs and breathing , too, not only against blood pressure. My PEF is not so voluminous , 310 ml as best if I have no flu)
Then – with time , samoe years ago Atacad began to be too strong to take every day, ( hypotension making) so nowadays I use it against acute hypertension only, and daily Salures 5 mg only, but if it happens something ( stressful things) that the blood pressure goes up too much to 170/95 or more , so ambulatory I take 8 mg Atacand once a day , and during some 1-2-3- days the blood pressure again stabilizes so that bendroflumetazid 5 mg is again enough for me . For me Atacand is a good acute medicin ( before I used it so long period that pehrhaps my body develoedp receptors for it and they are now ready). I feel so that Atacand is lung- and kidney diuretics. better perhaps to say . anti- pulmonar oedem drug and even diuretics some way. Any how easier to breath. But of cause it is individual, but i dont use more than 4 mg or 8 mg per day when I have troubles with acute blood pressure. ( Because I have mild vitium cordis, so I feel pressure toward lungs, sometimes, too). So I am sure Atacand can be beneficial in ARDS of COVID-19 NCP, especially when both heart, kidney and lung are compromized. What is a good dose, I can not say to others, but for me 4 mg- or 8 mg is already a real dose and it is cumulating during time.
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