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2020 ; 167
(ä): 108349
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Delineating clinical characteristics and comorbidities among 206 COVID-19
deceased patients in India: Emerging significance of renin angiotensin system
derangement
#MMPMID32712124
Majeed J
; Ajmera P
; Goyal RK
Diabetes Res Clin Pract
2020[Sep]; 167
(ä): 108349
PMID32712124
show ga
AIM: While there are rampant deaths reported worldwide due to novel corona virus
(COVID-19) on one side, hypertension, diabetes and renal failure are emerging
comorbidities with mortality risk due to respiratory failure on the other side.
The link of these morbidities with renin angiotensin system (RAS) and angiotensin
converting enzyme-2 (ACE2) as the site of the multiplication of COVID-19 has
widely been accepted. The objective of this research report was to delineate the
clinical characteristics with COVID-19 infection with RAS and to consider its
significance not just for the search of novel antiviral drugs, but for the
management and prevention of death of patients with COVID-19. METHODS: It was a
retrospective case series analysis of demographic and clinical data with
associated comorbidities of 206 deaths reported in India up to 10th April 2020.
The data were available from the official release from Ministry of Health and
Family welfare, Government of India. This was followed by a literature search to
correlate the available evidence for their possible relationship with RAS.
RESULTS: The demographic data were consistent with those reported from other
countries. The death (53.4%) was more common in patients with age above 60 years
and men (69.3%) were more susceptible as compared to women (30.68%).We found that
50.5% of the deceased patients had pre-existing comorbidities. Diabetes and
hypertension were the major comorbidities in 27.8% and 22.1% of the deceased
cases respectively. Although respiratory and cardiac problems were prevalent at
the time of death, the pre-existing pulmonary disease was comparatively less
prevalent. Only 13.6% of the deceased were having pre-existing respiratory
problems and 6.2% had cardiac ailments. We could correlate the reports that RAS
plays a significant role in the prognosis of the disease. CONCLUSIONS: Patients
with cardiovascular diseases, diabetes mellitus and hypertension are at greater
risk for developing COVID-19 infection. There may be massive derangement of the
entire RAS after the attack of COVID-19 and hence, patients with these
pre-existing comorbidities and on ACE inhibitors or angiotensin receptor blockers
should be monitored carefully considering the role of RAS in the prognosis of
COVID-19 infections.
|*Renin-Angiotensin System
[MESH]
|Adult
[MESH]
|Angiotensin Receptor Antagonists/therapeutic use
[MESH]
|Angiotensin-Converting Enzyme 2
[MESH]
|Angiotensin-Converting Enzyme Inhibitors/therapeutic use
[MESH]