rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2020-04-11rpcardio-2165Research ArticlePAGES OF RUSSIAN NATIONAL SOCIETY OF EVIDENCE-BASED PHARMACOTHERAPYСТРАНИЦЫ НАЦИОНАЛЬНОГО ОБЩЕСТВА ДОКАЗАТЕЛЬНОЙ ФАРМАКОТЕРАПИИTreatment of Patients with COVID-19 and Concomitant Cardiovascular Diseases: Do not Forget About the Principles of Evidence-based MedicineЛечение больных с COVID-19 и сопутствующими сердечно-сосудистыми заболеваниями: не забывать о принципах доказательной медициныМарцевичС. Ю.MartsevichS. Yu.

Марцевич Сергей Юрьевич – доктор медицинских наук, профессор, руководитель отдела профилактической фармакотерапии

Sergey Yu. Martsevich – MD, PhD, Professor, Head of Department of Preventive Pharmacotherapy

sergeymartsevich@mail.ruНациональный медицинский исследовательский центр терапии и профилактической медициныРоссияNational Medical Research Center for Therapy and Preventive MedicineRussian Federation202022042020162273276Copyright © Martsevich S.Y., 20202020Марцевич С.Ю.Martsevich S.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/2165

The recent discussion about the dangers of using angiotensin-converting-enzyme (ACE) inhibitors and angiotensin II receptor antagonists (ARA) in patients with COVID-19 is analyzed in the article. There is controversy over the hypothesis that these drugs can be factors contributing to an unfavorable outcome of a viral disease, as well as the absence of any clinical evidence for this hypothesis. The opinion that withdrawal of ACE inhibitors and ARA in patients with COVID-19 may increase the risk of adverse outcomes is presented.

В статье анализируется дискуссия, возникшая в последнее время по поводу опасности применения ингибиторов ангиотензинпревращающего фермента (иАПФ) и антагонистов рецепторов ангиотензина II (АРА) у больных с COVID-19. Отмечается спорность самой гипотезы о том, что эти препараты могут быть факторами, способствующими неблагоприятным исходам вирусного заболевания, а также отсутствие у этой гипотезы каких-либо клинических доказательств. Высказывается мнение, что отмена ИАПФ и АРА у больных с COVID-19 может увеличить риск неблагоприятного исхода.

COVID-19ингибиторы ангиотензинпревращающего ферментаантагонисты рецепторов ангиотензинаCOVID-19angiotensin converting enzyme inhibitorsangiotensin receptor antagonistsReferencesРоссийский статистический ежегодник. М.: Росстат; 2019.Russian statistical yearbook. Moscow: Rosstat; 2019 (In Russ.)Yu C.M. Cardiovascular complications of severe acute respiratory syndrome. Postgrad Med J. 2006;82:140-4. DOI:10.1136/pgmj.2005.037515.Yu C.M. Cardiovascular complications of severe acute respiratory syndrome. Postgrad Med J. 2006;82:140-4. DOI:10.1136/pgmj.2005.037515.Xiong T.Y., Redwood S., Prendergast B., Chen M. Coronaviruses and cardiovascular system: acute and long-term complications. Eur Heart J. 2020; DOI:10.1093/eurheartj/ehaa231.Xiong T.Y., Redwood S., Prendergast B., Chen M. Coronaviruses and cardiovascular system: acute and long-term complications. Eur Heart J. 2020; DOI:10.1093/eurheartj/ehaa231.Libby P., Simon D.L. Inflammation and thrombosis: the clot thickens. Circulation. 2001;103:1718-20. DOI:10.1161/01.cir.103.13.1718.Libby P., Simon D.L. Inflammation and thrombosis: the clot thickens. Circulation. 2001;103:1718-20. DOI:10.1161/01.cir.103.13.1718.Fedson D.S., Rordam O.M. Testing Ebola patients: a “bottom up” approach using generic statins and angiotensin receptor blockers. Int J Infect Dis. 2015;36:80-4.Fedson D.S., Rordam O.M. Testing Ebola patients: a “bottom up” approach using generic statins and angiotensin receptor blockers. Int J Infect Dis. 2015;36:80-4.Fedson D.S., Opal S., Rordam O.M. Hiding in plain sight: an approach to treating patients with severe COVID-10 infection. mBio. 11:e00398-20. DOI:10.1128/mBio.00398-20.Fedson D.S., Opal S., Rordam O.M. Hiding in plain sight: an approach to treating patients with severe COVID-10 infection. mBio. 11:e00398-20. DOI:10.1128/mBio.00398-20.Sommerstein R., Grani C. Rapid response: re: preventing a covid-19 pandemic: ACE inhibitors as a potential risk factor for fatal Covid-19. BMJ. 2020;368:m810.Sommerstein R., Grani C. Rapid response: re: preventing a covid-19 pandemic: ACE inhibitors as a potential risk factor for fatal Covid-19. BMJ. 2020;368:m810.Diaz J.H. Hypothesis: angiotensin-converting enzyme inhibitors and angiotensin receptor blockers may increase the risk of severe COVID-19. J Travel Med. 2020 Mar 18. pii: taaa041. DOI:10.1093/jtm/taaa041.Diaz J.H. Hypothesis: angiotensin-converting enzyme inhibitors and angiotensin receptor blockers may increase the risk of severe COVID-19. J Travel Med. 2020 Mar 18. pii: taaa041. DOI:10.1093/jtm/taaa041.Guan W., Ni Z., Liang W., et al. Clinical characteristics of coronavirus disease in China. N Engl J Med. 2020, February 28. DOI:10.1056/MEJMoa2002032.Guan W., Ni Z., Liang W., et al. Clinical characteristics of coronavirus disease in China. N Engl J Med. 2020, February 28. DOI:10.1056/MEJMoa2002032.Aronson J.K., Ferner R.E. Angiotensin converting enzyme inhibitors and angiotensin receptor blockers in COVID-19 [cited by April 14, 2020]. Available from: https://www.cebm.net/covid-19/angiotensin-converting-enzyme-ace-inhibitors-and-angiotensin-receptor-blockers-in-covid-19/.Aronson J.K., Ferner R.E. Angiotensin converting enzyme inhibitors and angiotensin receptor blockers in COVID-19 [cited by April 14, 2020]. Available from: https://www.cebm.net/covid-19/angiotensin-converting-enzyme-ace-inhibitors-and-angiotensin-receptor-blockers-in-covid-19/.Aronson J.A., Ferner R.E. Drugs and the renin-angiotensin system in covid-19. BMJ. 2020;369:m1313. DOI:10.1136/bmj.m1313.Aronson J.A., Ferner R.E. Drugs and the renin-angiotensin system in covid-19. BMJ. 2020;369:m1313. DOI:10.1136/bmj.m1313.Sarzani R. Relationship between COVID-19 and rennin-angiotensin-aldosterone-system blockers: hasty speculations may be dangerous. BMJ. 2020;368:m810.Sarzani R. Relationship between COVID-19 and rennin-angiotensin-aldosterone-system blockers: hasty speculations may be dangerous. BMJ. 2020;368:m810.Gurwitz D. Angiotensin receptor blockers as tentative SARS-CoV-2 therapeutics. Drug Disc Res. 2020. DOI:10.1002/ddr.21656.Gurwitz D. Angiotensin receptor blockers as tentative SARS-CoV-2 therapeutics. Drug Disc Res. 2020. DOI:10.1002/ddr.21656.Kuster G., Pfister O., Burkard T., et al. SARS-CoV2: should inhibitors of the renin-angiotensin system be withdrawn in patients with COVID-19? Eur Heart J. 2020 Mar 20. pii: ehaa235. DOI:10.1093/eurheartj/ehaa235.Kuster G., Pfister O., Burkard T., et al. SARS-CoV2: should inhibitors of the renin-angiotensin system be withdrawn in patients with COVID-19? Eur Heart J. 2020 Mar 20. pii: ehaa235. DOI:10.1093/eurheartj/ehaa235.Vaduganathan M., Vardeny O., Michel T., et al. Renin-Angiotensin-Aldosterone System Inhibitors in Patients with Covid-19. N Engl J Med. 2020 Mar 30. DOI:10.1056/NEJMsr2005760.Vaduganathan M., Vardeny O., Michel T., et al. Renin-Angiotensin-Aldosterone System Inhibitors in Patients with Covid-19. N Engl J Med. 2020 Mar 30. DOI:10.1056/NEJMsr2005760.Position Statement of the ESC Council on Hypertension on ACE-Inhibitors and Angiotensin Receptor Blockers [cited by April 14, 2020]. Available from: https://www.escardio.org/Councils/Council-on-Hypertension-(CHT)/News/position-statement-of-the-esc-council-on-hypertension-on-ace-inhibitors-and-ang.Position Statement of the ESC Council on Hypertension on ACE-Inhibitors and Angiotensin Receptor Blockers [cited by April 14, 2020]. Available from: https://www.escardio.org/Councils/Council-on-Hypertension-(CHT)/News/position-statement-of-the-esc-council-on-hypertension-on-ace-inhibitors-and-ang.

The authors declare that there are no conflicts of interest present.