Angiotensin II Receptor Blockers and Angiotensin-Converting Enzyme Inhibitors Usage is Associated with Improved Inflammatory Status and Clinical Outcomes in COVID-19 Patients With Hypertension

Guang Yang; Zihu Tan; Ling Zhou; Min Yang; Lang Peng; Jinjin Liu; Jingling Cai; Ru Yang; Junyan Han; Yafei Huang; Shaobin He

The copyright holder for this preprint (which was not peer-reviewed) is . https://doi.org/10.1101/2020.03.31.20038935 doi: medRxiv preprint stimulating adaptive response and inducing the elevated production of inflammation cytokines. 25, 26 AT II, an effector peptide of the RAS, which is responsible for the pathophysiology of hypertension, 27 has also been demonstrated to be capable of inducing the production of IL-6, IL-1β, TNFα, IFNγ, IL-17 and IL-23 in multiple animal models. 28 Not surprisingly, treatment of hypertension patients with ACEIs and ARBs, which functional through reducing the level of AT II and increasing the expression of ACE2, effectively downregulated the production of inflammatory cytokines. 29 Increased levels of inflammatory cytokines has also been observed in COVID-19 patients with or without hypertension as a coexisting illness. Huang et al reported that the plasma concentrations of IL-1β, IL-1RA, IFNγ, TNFα and other cytokines were significantly higher in both ICU patients and non-ICU patients with SARS-CoV-2 infection than in healthy adults.