Swiss researchers warn that certain popular blood pressure medications, as well as having diabetes, may make the effects of the coronavirus more dangerous.
In a letter published in The Lancet Respiratory Medicine on March 11, researchers warned that the coronavirus uses the angiotensin-converting enzyme 2 (ACE2) to bind to their targets. This means that those with increased ACE2 expression, such as those with type 1 or type 2 diabetes, face an increased risk of severe or fatal effects from developing COVID-19, the illness caused by the coronavirus.
This also means that those taking ACE inhibitors or angiotensin II type-1 receptor blockers (ARBs) may also face more severe and potentially deadly effects. This includes Diovan (valsartan), Avapro (irbesartan), Cozaar (losartan), Benicar (olmesartan) and similar drugs.
ACE2 expression can also be increased through the use of ibuprofen and thiazolidinediones, the researchers warned.
The U.S. Centers for Disease Control and Prevention (CDC) report that, as of March 16, there were 3,487 confirmed cases in the U.S., and at least 68 deaths. Many areas have shut down schools, bars, and any venues where large numbers of people gather and life in the U.S. and a number of other countries, for all intents and purposes, is on hold.
The researchers looked at data on 52 intensive care unit patients with COVID-19, 32 of whom died. They also looked at a study including 1,099 patients, and a third study involving 140 patients.
According to their findings, the most frequent comorbidities reported in the three studies were patients treated with ACE Inhibitors.
“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,” the researchers warned. “We therefore hypothesize that diabetes and hypertension treatment with ACE2-stimulating drugs increases the risk of developing severe and fatal COVID-19.”
The researchers expressed concern that their findings could lead to questions over how to treat COVID-19 because ACE2 is looked at as a way to reduce inflammation. In addition, they called for more research into the possibility that genetic predisposition to the coronavirus and similar viruses may be caused by ACE2 polymorphisms linked to diabetes, cerebral stroke and hypertension. This genetic predisposition is frequently expressed in Asian populations.
“We suggest 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,” the researchers concluded.