In an article written by Lei Fang, George Karakiulakis, Michael Roth published in The Lancet on March 11, the authors have found links of COVID-19 infection with cerebrovascular diseases, diabetes, hypertension and coronary heart diseases.
In the article titled ‘Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection?’ the authors state that the most distinctive comorbidities of 32 non-survivors from a group of 52 intensive care unit patients with novel coronavirus disease 2019 (COVID-19) in the study by Xiaobo Yang and colleagues were cerebrovascular diseases (22%) and diabetes (22%).
Citing another study which included 1099 patients with confirmed COVID-19, they asserted that 173 of them had severe disease with comorbidities of hypertension (23·7%), diabetes mellitus (16·2%), coronary heart diseases (5·8%), and cerebrovascular disease (2·3%).
They cited a third study which was conducted on 140 patients who were admitted to hospital with COVID-19, of them 30% had hypertension and 12% had diabetes.
Based on their study the authors hypothesise that diabetes and hypertension treatment with angiotensin-converting enzyme 2 (ACE2)-stimulating drugs increases the risk of developing severe and fatal COVID-19.
Concluding that the sensitivity of an individual might result from a combination of both therapy and ACE2 polymorphism, the authors suggested that patients with cardiac diseases, hypertension, or diabetes, who are treated with ACE2-increasing drugs, are at higher risk for severe COVID-19 infection and, therefore, should be monitored for ACE2-modulating medications, such as ACE inhibitors or ARBs.
They further suggested that based on a PubMed search on Feb 28, 2020, they did not find any evidence to suggest that antihypertensive calcium channel blockers increased ACE2 expression or activity, therefore these could be a suitable alternative treatment in these patients.
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