Protecting older patients with cardiovascular diseases from COVID-19 complications using current medications

Autor: Tomasz Grodzicki, Nikos Werner, A. Benetos, Chakravarthi Rajkumar, Francesco U.S. Mattace-Raso, Timo E. Strandberg, Hugo Clemente, Gulistan Bahat, Athanase Benetos, Marilia Andreia Fernandes, Manuel Martínez-Sellés, Andrea Ungar, Mariana Alves
Přispěvatelé: HUS Internal Medicine and Rehabilitation, Timo Strandberg / Principal Investigator, Department of Medicine, Clinicum, University of Helsinki, Internal Medicine
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Enfermedad cardiovascular
Angiotensin-Converting Enzyme Inhibitors
030204 cardiovascular system & hematology
Cardiovascular Diseases / drug therapy
Renin-Angiotensin System
0302 clinical medicine
RAAS
Renin-Angiotensin System / drug effects
INFECTION
030212 general & internal medicine
Vitamin D
VITAMIN-D
media_common
RISK
Aspirin
OUTCOMES
Medicamento
Diabetes
ASSOCIATION
NSAID
3. Good health
PREVALENCE
Antiarrhytmic
Cardiovascular Diseases
Anticoaculant
RECEPTOR BLOCKERS
medicine.drug
Drug
medicine.medical_specialty
Statin
medicine.drug_class
media_common.quotation_subject
Infecciones por coronavirus
Anciano
Angiotensin Receptor Antagonists
Special Article
03 medical and health sciences
SDG 3 - Good Health and Well-being
Diabetes mellitus
medicine
Coagulopathy
Humans
DRUGS
Intensive care medicine
Pandemics
Aged
Polypharmacy
SARS-CoV-2
business.industry
SARS-CoV-2 / pathogenicity
COVID-19
Angiotensin Receptor Antagonists / therapeutic use
HCC MED
medicine.disease
STATIN USE
COVID-19 Drug Treatment
CONVERTING ENZYME-INHIBITORS
3121 General medicine
internal medicine and other clinical medicine
Propensity score matching
SARS-CoV-2 / isolation & purification
Observational study
business
Colchicine
Angiotensin-Converting Enzyme Inhibitors / therapeutic use
COVID-19 / diagnosis
Zdroj: European Geriatric Medicine, 12(4), 725-739. Elsevier Masson
ABACUS. Repositorio de Producción Científica
Universidad Europea (UEM)
European Geriatric Medicine
ISSN: 1878-7649
Popis: Key summary points Aim To review current cardiovascular medications for benefits and potential harms during COVID-19. Findings Several cardiovascular drugs have a potential to protect patients with COVID-19, although evidence is largely based on observational studies and age-specific data are scarce. Message Most current cardiovascular drugs can be safely continued during COVID-19, but general conditions common in older patients must be considered. Supplementary Information The online version contains supplementary material available at 10.1007/s41999-021-00504-5.
Purpose In the pathogenesis of severe COVID-19 complications, derangements of renin–angiotensin–aldosterone system (RAAS), vascular endothelial dysfunction leading to inflammation and coagulopathy, and arrhythmias play an important role. Therefore, it is worth considering the use of currently available drugs to protect COVID-19 patients with cardiovascular diseases. Methods We review the current experience of conventional cardiovascular drugs [angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers, anticoagulants, acetosalicylic acid, antiarrhythmic drugs, statins] as well as some other drug classes (antidiabetic drugs, vitamin D and NSAIDs) frequently used by older patients with cardiovascular diseases. Data were sought from clinical databases for COVID-19 and appropriate key words. Conclusions and recommendations are based on a consensus among all authors. Results Several cardiovascular drugs have a potential to protect patients with COVID-19, although evidence is largely based on retrospective, observational studies. Despite propensity score adjustments used in many analyses observational studies are not equivalent to randomised controlled trials (RCTs). Ongoing RCTs include treatment with antithrombotics, pulmonary vasodilators, RAAS-related drugs, and colchicine. RCTs in the acute phase of COVID-19 may not, however, recognise the benefits of long term anti-atherogenic therapies, such as statins. Conclusions Most current cardiovascular drugs can be safely continued during COVID-19. Some drug classes may even be protective. Age-specific data are scarce, though, and conditions which are common in older patients (frailty, comorbidities, polypharmacy) must be individually considered for each drug group. Supplementary Information The online version contains supplementary material available at 10.1007/s41999-021-00504-5.
Databáze: OpenAIRE
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