Clinical effects of angiotensin-converting-enzyme inhibitors on lung
computed tomography findings in patients with COVID-19 pneumonia: Is it
useful?
Abstract
Aim: Angiotensin-converting enzyme 2 (ACE2) has a significant
physiological role in the renin – angiotensin – aldosterone system
(RAAS) pathway. The ACE2 receptor acts as a virus receptor in the
pathogenesis of severe acute respiratory syndrome coronavirus 2
(SARS-CoV-2) disease. In this study, we aimed to investigate the effects
of ACEIs use on radiological imaging and clinical course in COVID-19.
Methods: In this study, patients who had been using medications for the
diagnosis of hypertension and who were hospitalized in Haydarpasa Numune
Training and Research Hospital due to COVID-19 pneumonia were
retrospectively evaluated. Results: The mean age of 107 patients
included in this study was 68,49±11,95, and 50.5% (n = 54) of them were
male. The patients were divided into two separate study groups as ACEIs
users and non-users. In the first of these groups, 55 patients were
using ACEIs due to hypertension. In the second group, 52 patients were
using calcium channel blockers (CCBs), β-blockers, alpha-2 blockers, or
diuretics, alone or in combination. When the lung computed tomography
images were examined, multilobar findings were less common in the ACEIs
group, which was remarkable (p <0.001). When the clinical
endpoint was evaluated, the findings showed that the mortality rates
were different in the groups ACEIs users and non-users (12.7% vs.
32.7%, respectively, p=0.013). Conclusion: Although the role of RAAS
blockade in COVID-19 is still not fully elucidated, we have shown that
COVID-19 progresses with less damage in the lungs with patients who have
been using ACEIs.