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Are patients with hypertension and diabetes at increased risk for COVID-19?

thelancet.com

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Re: Are patients with hypertension and diabetes at increased risk for COVID-19?

#2
From the article: "ACE2 can also be increased by thiazolidinediones and ibuprofen. These data suggest that ACE2 expression is increased in diabetes and treatment with ACE inhibitors and ARBs increases ACE2 expression. Consequently, the increased expression of ACE2 would facilitate infection with COVID-19. We therefore hypothesise that diabetes and hypertension treatment with ACE2-stimulating drugs increases the risk of developing severe and fatal COVID-19."

Re: Are patients with hypertension and diabetes at increased risk for COVID-19?

#3

From the article: "ACE2 can also be increased by thiazolidinediones and ibuprofen. These data suggest that ACE2 expression is increased in diabetes and treatment with ACE inhibitors and ARBs increases ACE2 expression. Consequently, the increased expression of ACE2 would facilitate infection with COVID-19. We therefore hypothesise that diabetes and hypertension treatment with ACE2-stimulating drugs increases the risk…

Considering that lisinopril (Prinivil, Zestrel, etc, an ACE inhibitor) is, according to any list I could find, easily in the top 10 meds prescribed in the US (and by some top three or number one), this is something that should definitely be more publicly known.

I’m not saying anyone should just stop taking their hypertension drugs, that’s a horrible idea. But if you do suspect that you might have COVID-19, you should probably call your doctor - there’s no shortage of other options.

One of those lists: https://www.medicinenet.com/top_drugs_prescribed_in_the_us/v...

Re: Are patients with hypertension and diabetes at increased risk for COVID-19?

#5
Ibuprofen, along with paracetamol, is generally considered very safe. All over the world they are prescribed for any kind of pain, fever, inflammation or discomfort. Of course, there are some known side effects, but they are generally considered minor.

Does it make sense that a virus would evolve to favour these conditions? Or is it just an unfortunate coincidence? I guess it depends on whether the virus being "worse" means it helps spread faster, or just compromises the host faster - after all, the virus doesn't gain from killing its host. Also, animals don't get treated with NSAIDs to the same degree, so if nCovid-19 came from a non-human host that's another argument for it being coincidence.

Re: Are patients with hypertension and diabetes at increased risk for COVID-19?

#7
post #6

why is this keep popping up??? https://news.ycombinator.com/item?id=22582568 https://news.ycombinator.com/item?id=22576721 stop spamming this

Those other ones got flagged, but this is from the lancet which is a credible source.

Re: Are patients with hypertension and diabetes at increased risk for COVID-19?

#8

From the article: "ACE2 can also be increased by thiazolidinediones and ibuprofen. These data suggest that ACE2 expression is increased in diabetes and treatment with ACE inhibitors and ARBs increases ACE2 expression. Consequently, the increased expression of ACE2 would facilitate infection with COVID-19. We therefore hypothesise that diabetes and hypertension treatment with ACE2-stimulating drugs increases the risk…

Considering that lisinopril (Prinivil, Zestrel, etc, an ACE inhibitor) is, according to any list I could find, easily in the top 10 meds prescribed in the US (and by some top three or number one), this is something that should definitely be more publicly known. I’m not saying anyone should just stop taking their hypertension drugs, that’s a horrible idea. But if you do suspect that you might have COVID-19, you should…

A virologist gives a different view in this thread:

https://twitter.com/angie_rasmussen/status/12389469408820060...

Btw, ACE2 expression is decreased in unmedicated diabetics and HTN patients and the elderly which would imply that those groups should have some degree of protection from the virus (ceteris paribus, obviously). In fact that seems to be exactly the opposite of what we see. Some research even indicates that ACE2 could help prevent ARDS-induced lung injury:

https://www.nature.com/articles/srep27911

But in that article the injury wasn't induced by COVID-19 so really we don't know enough yet.

(Ref. for decreased ACE2 expression in diabetes: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2992757/)

Re: Are patients with hypertension and diabetes at increased risk for COVID-19?

#9

From the article: "ACE2 can also be increased by thiazolidinediones and ibuprofen. These data suggest that ACE2 expression is increased in diabetes and treatment with ACE inhibitors and ARBs increases ACE2 expression. Consequently, the increased expression of ACE2 would facilitate infection with COVID-19. We therefore hypothesise that diabetes and hypertension treatment with ACE2-stimulating drugs increases the risk…

Considering that lisinopril (Prinivil, Zestrel, etc, an ACE inhibitor) is, according to any list I could find, easily in the top 10 meds prescribed in the US (and by some top three or number one), this is something that should definitely be more publicly known. I’m not saying anyone should just stop taking their hypertension drugs, that’s a horrible idea. But if you do suspect that you might have COVID-19, you should…

It is widely known (to some extent) that preexisting conditions severely contribute to the harm of covid-19.

Re: Are patients with hypertension and diabetes at increased risk for COVID-19?

#10

From the article: "ACE2 can also be increased by thiazolidinediones and ibuprofen. These data suggest that ACE2 expression is increased in diabetes and treatment with ACE inhibitors and ARBs increases ACE2 expression. Consequently, the increased expression of ACE2 would facilitate infection with COVID-19. We therefore hypothesise that diabetes and hypertension treatment with ACE2-stimulating drugs increases the risk…

are those ACE inhibitors also prescribed in China? I really doubt that
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