Angiotensin-Converting Enzyme(ACE)Inhibitors May Moderate COVID-19 Hyperinflammatory Response:An Observational Study with Deep Immunophenotyping  

作　　者：Venkata R.Duvvuri Andrew Baumgartner Sevda Molani Patricia V.Hernandez Dan Yuan Ryan T.Roper Wanessa F.Matos Max Robinson Yapeng Su Naeha Subramanian Jason D.Goldman James R.Heath Jennifer J.Hadlock 

机构地区：[1]Institute for Systems Biology,Seattle,WA,USA [2]Department of Bioengineering,University of Washington,Seattle,WA,USA [3]Washington University,St.Louis,MO,USA [4]Swedish Center for Research and Innovation,Swedish Medical Center,Seattle,WA,USA [5]Providence St.Joseph Health,Renton,WA,USA [6]Division of Allergy and Infectious Diseases,University of Washington,Seattle,WA,USA.

出　　处：《Health Data Science》2022年第1期1-14,共14页健康数据科学（英文）

摘　　要：Background:Angiotensin-converting enzyme inhibitors(ACEi)and angiotensin-II receptor blockers(ARB),the most commonly prescribed antihypertensive medications,counter renin-angiotensin-aldosterone system(RAAS)activation via induction of angiotensin-converting enzyme 2(ACE2)expression.Considering that ACE2 is the functional receptor for SARS-CoV-2 entry into host cells,the association of ACEi and ARB with COVID-19 outcomes needs thorough evaluation.Methods:We conducted retrospective analyses using both unmatched and propensity score(PS)-matched cohorts on electronic health records(EHRs)to assess the impact of RAAS inhibitors on the risk of receiving invasive mechanical ventilation(IMV)and 30-day mortality among hospitalized COVID-19 patients.Additionally,we investigated the immune cell gene expression profiles of hospitalized COVID-19 patients with prior use of antihypertensive treatments from an observational prospective cohort.Results:The retrospective analysis revealed that there was no increased risk associated with either ACEi or ARB use.In fact,the use of ACEi showed decreased risk for mortality.Survival analyses using PS-matched cohorts suggested no significant relationship between RAAS inhibitors with a hospital stay and in-hospital mortality compared to non-RAAS medications and patients not on antihypertensive medications.From the analysis of gene expression profiles,we observed a noticeable up-regulation in the expression of 1L1R2(an anti-inflammatory receptor)and RETN(an immunosuppressive marker)genes in monocytes among prior users of ACE inhibitors.Conclusion:Overall,the findings do not support the discontinuation of ACEi or ARB treatment and suggest that ACEi may moderate the COVID-19 hyperinflammatory response.

关 键 词：HYPERTENSIVE INFLAMMATORY ANGIOTENSIN 

分 类 号：R563.1[医药卫生—呼吸系统]