ACE and ARA inhibitors are commonly taken through cardiac patients to lower blood pressure and treat center failure. There is conflicting evidence of the possible clinical influence of ACE and ARA inhibitors on patients with COVID-19. Some preclyconic investigations have raised protection considerations. in patients with COVID-19, preliminary knowledge hypothesizes that renin-angiotensin-aldosterone (SRAA) inhibitors may gain benefits for COVID-19 patients by cutting off acute lung damage and preventing angiotensin-II-mediated lung inflammation.
Given the common use of these agents worldwide, evidence from randomized clinical trials is urgent to consult the control of COVID-19 patients.
The membrane-associated angiotensin conversion enzyme 2 (ACE2) is the functional receptor of SARS-CoV-2, the virus guilty of coronavirus 2019 disease (COVID-19). ARA inhibitors.
The BRACE CORONA trial, a phase-four, randomized, academic-led study that tested two strategies: transient withdrawal of ACE / ARB inhibitors for 30 days compared to continuation of ACE / ARB inhibitors in patients taking these drugs chronically and they were hospitalized with a COVID-19 diagnosis. The number one endpoint is the number of days alive and out of the hospital at 30 days.
Patients who used more than 3 antihypertensive or sacubitril/valsartan, or who were hemodynamically volatile in the presentation, were excluded from the study.
The trial recruited 659 patients from 29 sites in Brazil. All participants were a chronic ACE inhibitor or ARA and were hospitalized by COVID-19. Patients were randomly assigned to prevent the ACE/ARA inhibitor for 30 days or continue with ACE/ARA.
The average number of days alive and out of the hospital was 21. 9 days for patients who discontinued IEC/ARA and 22. 9 days for patients who continued with these medications. The average ratio of live and non-hospitalized days between suspended and non-detained equipment 0. 95 (95% confidence period [CI] 0. 90 to 1. 01, p -0. 09). The average difference between teams -1. 1 days (95% CI -2. 33 to 0. 17).
The proportion of living and non-hospitalized patients at the end of 30 days in the ACE/ARA inhibitory organization with suspected completion was 91. 8% compared to 95% in the ongoing organization. A mortality rate similar to 30 days was observed for patients who continued and suspicious ER/ARA (2. 8% vs. 2. 7%, respectively, with a threat rate of 0. 97).
“These are the first random knowledge comparing the role of continuation or suspension of ECA and ARA inhibitors in COVID-19 patients,” said Professor Renato Lopes, principal investigator at the Duke Clinical Research Institute, Durham, USA. “Usa. ” In patients hospitalized with COVID-19, the suspension of ACE and ARA inhibitors for 30 days did not increase the number of days alive and out of the hospital.