PMC:7170368 / 5085-9307 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/7170368","sourcedb":"PMC","sourceid":"7170368","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7170368","text":"Results\nA total of 417 COVID-19 patients were admitted to the Shenzhen Third People’s Hospital as of 23 February 2020. Among these patients, 51 (12.23%) had hypertension. Nine patients (17.6%) with Grade 1hypertension did not take any antihypertensive drugs during hospitalization and were excluded from the subsequent analysis. The other 42 patients (82.4%) receiving antihypertensive therapy were included in further studies. The 42 analyzed patients were divided into two groups based on antihypertensive therapies: the ACEI/ARB group (17 patients) included patients treated with ACEI or ARB drugs, and the non-ACEI/ARB group (25 patients) included patients treated with other antihypertensive drugs, including calcium channel blockers (CCBs), β-blockers and diuretics. Eight patients (32%) in the non-ACEI/ARB group and 5 patients (29.41%)in the ACEI/ARB group had other comorbidities, such as type 2 diabetes (T2D) and coronary heart disease (CHD). The vast majority of hypertensive patients had received the current therapeutic regimens shown in supplementary Table S1 for over one year. The blood pressure of patients was well-controlled with the above therapeutic regimens during hospitalization.\nThe comparison of baseline characteristics between the two groups is summarized in supplementary Table S2. The median age of the analyzed subjects was 64.5 years (IQR, 55.8–69.0 years), and 57.1% of them were males. No significant differences in hypertension grades were observed between the ACEI/ARB group and the non-ACEI/ARB group. Both groups showed similar signs and symptoms. The median number of days from the onset of symptoms to hospital admission was 2.0 in the non-ACEI/ARB group and 3.0 in the ACEI/ARB group. Meanwhile, the median number of days from symptom onset to hospital discharge was 16.5 days in the non-ACEI/ARB group and 20.0 days in the ACEI/ARB group. The median heart rate and respiratory rate from the non-ACEI/ARB group were 90.5 bpm and 20.0, respectively. In comparison, the median heart rate and respiratory rate from the non-ACEI/ARB group were 80.0 bmp and 20.0, respectively. All baseline characteristics shown in Table S2 were not significantly different between the two groups.\nDuring hospitalization, 12 patients in the non-ACEI/ARB group (48%) were categorized into severe subgroups and one patient died. In contrast, in the ACEI/ARB group, only 4 patients (23.5%) were categorized into severe subgroups and no patients died (Figure 1(A)). The percentage of severe cases in the ACEI/ARB group was higher than that in the non-ACEI/ARB group, but this difference was not significant, possibly due to the small number of clinical cases. We next examined the effects of taking ACEI or ARB drugs on laboratory findings of COVID-19 patients with hypertension. As shown in Figure 1(B), there was a trend toward lower IL-6 levels in patients from the ACEI/ARB group. No marked variation in C-reactive protein (CRP) was observed between the two groups (Figure 1(B)). The absolute number of CD3+ and CD8+ T cells in the ACEI/ARB group was significantly higher than that in the non-ACEI/ARB group. There were no significant changes in CD4+ T cell counts between the two groups (Figure 1(C)). In addition, although the viral load was not different between the two groups at hospital admission, the peak viral load during hospitalization in the ACEI/ARB group was significantly lower than that in the non-ACEI/ARB group (Figure 1(D)). Other laboratory findings, such as white blood cell counts, neutrophil counts, platelet counts, and lactate dehydrogenase, are shown in supplementary Table S3, and no significant differences were observed between the two groups.\nFigure 1. Summarized clinical, inflammatory, immunological, and viral findings in the non-ACEI/ARB group and the ACE/ARB group. (A) The disease severity distribution of the two groups during hospitalization. (B) The levels of IL-6 and CRP in peripheral blood. (C) Absolute numbers of CD3+, CD4+, and CD8+ T cells in peripheral blood. (D) Viral load on hospital admission and maximum value during hospitalization. The data are expressed as the median and IQR. An unpaired t test was used, and P \u003c 0.05 was considered 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