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NEJM:肾素-血管紧张素-醛固酮系统抑制剂与Covid-19风险

2020-06-18 MedSci原创 MedSci原创

该研究发现服用五种常见降压药物的检测阳性患者中,Covid-19阳性的可能性或发生严重Covid-19的风险没有实质性增加。

由于新冠病毒的受体是血管紧张素转化酶2(ACE2),因此服用作用于肾素-血管紧张素-醛固酮系统药物的患者冠状病毒病2019(Covid-19)相关风险增加的可能性令人担忧。

近日,顶级医学期刊NEJM上发表了一篇研究文章,研究人员评估了先前使用ACE抑制剂、血管紧张素受体阻滞剂、β受体阻滞剂、钙通道阻滞剂或噻嗪类利尿剂治疗与Covid-19检测阳性或阴性结果以及检测结果阳性患者严重疾病(定义为重症监护、机械通气或死亡)可能性之间的关系。对每种药物类别进行倾向评分匹配后,研究人员使用贝叶斯方法比较了接受过这些药物治疗的患者和未接受治疗的患者(整体)和高血压患者的结局。预先设定至少有10个百分点的差异为显著差异。

在接受Covid-19检测的12594例患者中,共有5894例(46.8%)患者检测为阳性。这些患者中有1002名(17.0%)患有严重疾病。有高血压病史的患者为4357名(34.6%),其中2573名(59.1%)检测结果呈阳性。这些患者中有634名(24.6%)为重病。在任何单一药物和检测阳性可能性增加之间均无关联。在检测为阳性的患者中,没有一种药物与严重疾病风险的大幅增加相关。

由此可见,该研究发现服用五种常见降压药物的检测阳性患者中,Covid-19阳性的可能性或发生严重Covid-19的风险没有实质性增加。

同期另一篇:NEJM:肾素-血管紧张素系统阻滞剂与Covid-19风险

原始出处:

Harmony R. Reynolds.et al.Renin–Angiotensin–Aldosterone System Inhibitors and Risk of Covid-19.NEJM.2020.https://www.nejm.org/doi/full/10.1056/NEJMoa2008975

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    2021-04-17 jklm09
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    2020-06-19 cmsvly
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  5. [GetPortalCommentsPageByObjectIdResponse(id=1852408, encodeId=3ae518524088c, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Sat Apr 17 01:53:44 CST 2021, time=2021-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1746974, encodeId=08331e46974dc, content=<a href='/topic/show?id=30bb82634ae' target=_blank style='color:#2F92EE;'>#肾素-血管紧张素-醛固酮系统#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82634, encryptionId=30bb82634ae, topicName=肾素-血管紧张素-醛固酮系统)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e13235894775, createdName=lancelotzzl, createdTime=Sun Sep 13 07:53:44 CST 2020, time=2020-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1379254, encodeId=aaf713e92545c, content=<a href='/topic/show?id=ac549564240' target=_blank style='color:#2F92EE;'>#醛固酮#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95642, encryptionId=ac549564240, topicName=醛固酮)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aad0444, createdName=cmsvly, createdTime=Fri Jun 19 23:53:44 CST 2020, time=2020-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1589341, encodeId=8a571589341ff, content=<a href='/topic/show?id=fb0389e4373' target=_blank style='color:#2F92EE;'>#血管紧张素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89743, encryptionId=fb0389e4373, topicName=血管紧张素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5ce517702394, createdName=xiongliangxl, createdTime=Fri Jun 19 23:53:44 CST 2020, time=2020-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035311, encodeId=17781035311d5, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Jun 18 11:53:44 CST 2020, time=2020-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=602479, encodeId=a9a96024e998, content=<a href='/topic/show?id=46ce580e865' target=_blank style='color:#2F92EE;'>#新冠肺炎#</a>有关于胜诉血管紧张素和床不同系统,你自己的药物与新冠肺炎之间的关联,你有很多研究,这一次研究规模更大一点而已。大部分研究都认为你是高血压患者使用的药物时,也不应该停止, beContent=null, objectType=article, channel=null, level=null, likeNumber=151, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58078, encryptionId=46ce580e865, topicName=新冠肺炎)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Thu Jun 18 10:51:24 CST 2020, time=2020-06-18, status=1, ipAttribution=)]
    2020-06-18 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1852408, encodeId=3ae518524088c, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Sat Apr 17 01:53:44 CST 2021, time=2021-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1746974, encodeId=08331e46974dc, content=<a href='/topic/show?id=30bb82634ae' target=_blank style='color:#2F92EE;'>#肾素-血管紧张素-醛固酮系统#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82634, encryptionId=30bb82634ae, topicName=肾素-血管紧张素-醛固酮系统)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e13235894775, createdName=lancelotzzl, createdTime=Sun Sep 13 07:53:44 CST 2020, time=2020-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1379254, encodeId=aaf713e92545c, content=<a href='/topic/show?id=ac549564240' target=_blank style='color:#2F92EE;'>#醛固酮#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95642, encryptionId=ac549564240, topicName=醛固酮)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aad0444, createdName=cmsvly, createdTime=Fri Jun 19 23:53:44 CST 2020, time=2020-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1589341, encodeId=8a571589341ff, content=<a href='/topic/show?id=fb0389e4373' target=_blank style='color:#2F92EE;'>#血管紧张素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89743, encryptionId=fb0389e4373, topicName=血管紧张素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5ce517702394, createdName=xiongliangxl, createdTime=Fri Jun 19 23:53:44 CST 2020, time=2020-06-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035311, encodeId=17781035311d5, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Jun 18 11:53:44 CST 2020, time=2020-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=602479, encodeId=a9a96024e998, content=<a href='/topic/show?id=46ce580e865' target=_blank style='color:#2F92EE;'>#新冠肺炎#</a>有关于胜诉血管紧张素和床不同系统,你自己的药物与新冠肺炎之间的关联,你有很多研究,这一次研究规模更大一点而已。大部分研究都认为你是高血压患者使用的药物时,也不应该停止, beContent=null, objectType=article, channel=null, level=null, likeNumber=151, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58078, encryptionId=46ce580e865, topicName=新冠肺炎)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Thu Jun 18 10:51:24 CST 2020, time=2020-06-18, status=1, ipAttribution=)]
    2020-06-18 lovetcm

    #新冠肺炎#有关于胜诉血管紧张素和床不同系统,你自己的药物与新冠肺炎之间的关联,你有很多研究,这一次研究规模更大一点而已。大部分研究都认为你是高血压患者使用的药物时,也不应该停止

    0

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