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Targeting of renin-angiotensin system in COVID-19 patients affected by stroke:
Emerging concerns about detrimental vs benefit effect
#MMPMID32835018
Luzzi S
; Giotta Lucifero A
; Marasco S
; Del Maestro M
; Bellantoni G
; Gragnaniello C
Interdiscip Neurosurg
2020[Dec]; 22
(?): 100822
PMID32835018
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OBJECTIVE: The present short report summarizes some clinical characteristics of
six patients affected by stroke while being on angiotensin-converting enzyme
(ACE)2 inhibitors and angiotensin II receptor blockers (ARBs) before and during
COVID-19. METHODS: Medical charts and images of six patients affected by stroke
while being on ACE-Is and ARBs therapy before and during COVID-19 outbreak in
Lombardy region, Italy, were reviewed. RESULTS: Three patients had a dural sinus
thrombosis, whereas the remaining suffered by an arterial ischemia, which was a
middle cerebral artery occlusion in one case, and a posterior-inferior cerebellar
artery occlusion in the remaining two. All patients showed clinical features
typical of SARS-CoV-2 infection and positive chest CT scan, and were treated with
ACE-Is as needed. Hypercoagulability panel was negative in any case. A recovery
was achieved in all cases, although in a variable manner. CONCLUSIONS: Whether or
not and in which manner the pharmacomodulation of the renin-angiotensin system
may had affect the clinical course of the reported six COVID-19 patients affected
by stroke has to be still clarified. An urgent need of randomized clinical trials
aimed to assess the safety profile and neuroprotective properties of ACE-Is and
ARBs in COVID-19 patients diagnosed with stroke does exists.
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