Hypertension in patients hospitalized with COVID-19 in Wuhan, China: A single-center retrospective observational study

Zhenhua Zeng; Tong Sha; Yuan Zhang; Feng Wu; Hongbin Hu; Haijun Li; Jiafa Han; Wenhong Song; Qiaobing Huang; Zhongqing Chen

However, some scholars believe that the down-regulation of ACE2 expression after a neo coronavirus challenge aggravates lung injuries. This opinion mainly comes from animal model studies in multiple laboratories and a small sample clinical study. Studies have shown that ACE2 expression decreases after viral infection, causing acute lung injury; exogenous supplementation with ACE2 could alleviate acute lung injury 15 . Human recombinant ACE 2 (rhuACE2) and angiotensin II type 2 receptors protect mice from severe acute lung injuries induced by acid aspiration or sepsis 16 . It was found that patients with acute respiratory distress syndrome (ARDS) who were treated with rhuACE2 injections had rapidly decreasing levels of Ang II and increasing levels of Ang1-7 17 . The down-regulation of ACE2 caused the imbalance of ACE/Ang II and ACE2 and the activity of Ang II in the renin-angiotensin-aldosterone system (RAAS) was enhanced because of the lack of antagonism 17 . Ang II mediates increased pulmonary vascular permeability by binding to receptor AT1, and might also cause pulmonary vascular contraction, resulting in hydrostatic pressure elevation and pulmonary edema 10, 17 . More clinical evidence is required to determine whether the expression of ACE2 is down-regulated in humans after a coronavirus (including . CC-BY-ND 4.0 International license It is made available under a author/funder, who has granted medRxiv a license to display the preprint in perpetuity. Nevertheless, the results of our study suggest that in the widespread COVID-19 pandemic, the hypertensive population may need to quickly consider their choice of antihypertensive medications to reduce the possibility of developing severe pneumonia. Our investigation found that COVID-19 patients taking ACEI/ARB agents are younger than patients taking non-ACEI/ARB agents; this may be related to their doctor's prescribing habits.