Continuing versus suspending angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: Impact on adverse outcomes in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)

Detalhes bibliográficos
Autor(a) principal: Lopes, Renato D.
Data de Publicação: 2020
Outros Autores: Macedo, Ariane Vieira Scarlatelli, Silva, Pedro Gabriel Melo de Barros e, Moll-Bernardes, Renata Junqueira, Feldman, Andre, D'Andréa Saba Arruda, Guilherme, Souza, Andrea Silvestre de, Albuquerque, Denilson Campos de, Mazza, Lilian, Santos, Mayara Fraga, Salvador, Natalia Zerbinatti, Gibson, C. Michael, Granger, Christopher B., Alexander, John H., Souza, Olga Ferreira de
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/41422
Resumo: Instituto D'Or de Pesquisa e Ensino. Rio de Janeiro, RJ, Brasil / Duke University Medical Center. Duke Clinical Research Institute. Durham, NC, USA / Brazilian Clinical Research Institute, São Paulo, SP, Brasil / Rede D'Or São Luiz, São Paulo, SP, Brasil.
id CRUZ_0956306124ba7e40d5ead036254c7bd4
oai_identifier_str oai:www.arca.fiocruz.br:icict/41422
network_acronym_str CRUZ
network_name_str Repositório Institucional da FIOCRUZ (ARCA)
repository_id_str 2135
spelling Lopes, Renato D.Macedo, Ariane Vieira ScarlatelliSilva, Pedro Gabriel Melo de Barros eMoll-Bernardes, Renata JunqueiraFeldman, AndreD'Andréa Saba Arruda, GuilhermeSouza, Andrea Silvestre deAlbuquerque, Denilson Campos deMazza, LilianSantos, Mayara FragaSalvador, Natalia ZerbinattiGibson, C. MichaelGranger, Christopher B.Alexander, John H.Souza, Olga Ferreira de2020-05-27T15:47:20Z2020-05-27T15:47:20Z2020LOPES, Renato D. et al. Continuing Versus Suspending Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers: Impact on Adverse Outcomes in Hospitalized Patients With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). American Heart Journal, p. 1-27, May 2020.0002-8703https://www.arca.fiocruz.br/handle/icict/4142210.1016/j.ahj.2020.05.002engElsevierContinuing versus suspending angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: Impact on adverse outcomes in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleInstituto D'Or de Pesquisa e Ensino. Rio de Janeiro, RJ, Brasil / Duke University Medical Center. Duke Clinical Research Institute. Durham, NC, USA / Brazilian Clinical Research Institute, São Paulo, SP, Brasil / Rede D'Or São Luiz, São Paulo, SP, Brasil.Instituto D'Or de Pesquisa e Ensino. Rio de Janeiro, RJ, Brasil / Rede D'Or São Luiz. São Paulo, SP, Brasil / Santa Casa de São Paulo. São Paulo, SP, Brasil.Brazilian Clinical Research Institute, São Paulo, SP, Brasil.Instituto D'Or de Pesquisa e Ensino. Rio de Janeiro, RJ, Brasil.Instituto D'Or de Pesquisa e Ensino. Rio de Janeiro, RJ, Brasil / Rede D'Or São Luiz. São Paulo, SP, Brasil.Instituto D'Or de Pesquisa e Ensino. Rio de Janeiro, RJ, Brasil / Rede D'Or São Luiz. São Paulo, SP, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / Instituto D'Or de Pesquisa e Ensino. Rio de Janeiro, RJ, Brasil / Universidade Federal do Rio de Janeiro. Rio de Janeiro, RJ, Brazil.Instituto D'Or de Pesquisa e Ensino. Rio de Janeiro, RJ, Brasil / Harvard Medical School, Boston, MA, USA.Brazilian Clinical Research Institute, São Paulo, SP, Brasil.Instituto D'Or de Pesquisa e Ensino. Rio de Janeiro, RJ, Brasil.Instituto D'Or de Pesquisa e Ensino. Rio de Janeiro, RJ, Brasil.Harvard Medical School, Boston, MA, USA.Duke University Medical Center. Duke Clinical Research Institute. Durham, NC, USA.Duke University Medical Center. Duke Clinical Research Institute. Durham, NC, USA.Instituto D'Or de Pesquisa e Ensino. Rio de Janeiro, RJ, Brasil / Rede D'Or São Luiz. São Paulo, SP, Brasil.Angiotensin-converting enzyme-2 (ACE2) may increase due to upregulation in patients using angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB). Because renin-angiotensin system blockers increase levels of ACE2, a protein that facilitates coronavirus entry into cells, there is concern that these drugs could increase the risk of developing a severe and fatal form of COVID-19. The impact of discontinuing ACEI and ARBs in patients with COVID-19 remains uncertain.DESIGNBRACE CORONA is a pragmatic, multicenter, randomized, phase IV, clinical trial that aims to enroll around 500 participants at 32 sites in Brazil. Participants will be identified from an ongoing national registry of suspected and confirmed cases of COVID-19. Eligible patients using renin-angiotensin system blockers (ACEI/ARBs) with a confirmed diagnosis of COVID-19 will be randomized to a strategy of continued ACEI/ARB treatment versus temporary discontinuation for 30 days. The primary outcome is the median days alive and out of the hospital at 30 days. Secondary outcomes include progression of COVID-19 disease, all-cause mortality, death from vascular causes, myocardial infarction, stroke, transient ischemic attack, new or worsening heart failure, myocarditis, pericarditis, arrhythmias, thromboembolic events, hypertensive crisis, respiratory failure, hemodynamic decompensation, sepsis, renal failure, troponin, B-type natriuretic peptide, N-terminal-pro hormone and D-dimer levels.SARS-CoV-2ACE InhibitorAngiotensin Receptor BlockerCoronavirusCOVID-19SimAhead of Printinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-83132https://www.arca.fiocruz.br/bitstream/icict/41422/1/license.txt70425d8cb6e40fdcf4edd2ef0660b45bMD51ORIGINAL1-s2.0-S0002870320301381-main.pdf1-s2.0-S0002870320301381-main.pdfapplication/pdf4734347https://www.arca.fiocruz.br/bitstream/icict/41422/2/1-s2.0-S0002870320301381-main.pdfd3ed8514a186e1279ea1fb716e193c3fMD52TEXT1-s2.0-S0002870320301381-main.pdf.txt1-s2.0-S0002870320301381-main.pdf.txtExtracted texttext/plain43649https://www.arca.fiocruz.br/bitstream/icict/41422/3/1-s2.0-S0002870320301381-main.pdf.txte16baed2aee82134268d166c8467036cMD53icict/414222020-05-29 13:31:52.15oai:www.arca.fiocruz.br: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ório InstitucionalPUBhttps://www.arca.fiocruz.br/oai/requestrepositorio.arca@fiocruz.bropendoar:21352020-05-29T16:31:52Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)false
dc.title.pt_BR.fl_str_mv Continuing versus suspending angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: Impact on adverse outcomes in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
title Continuing versus suspending angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: Impact on adverse outcomes in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
spellingShingle Continuing versus suspending angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: Impact on adverse outcomes in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
Lopes, Renato D.
SARS-CoV-2
ACE Inhibitor
Angiotensin Receptor Blocker
Coronavirus
COVID-19
title_short Continuing versus suspending angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: Impact on adverse outcomes in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
title_full Continuing versus suspending angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: Impact on adverse outcomes in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
title_fullStr Continuing versus suspending angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: Impact on adverse outcomes in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
title_full_unstemmed Continuing versus suspending angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: Impact on adverse outcomes in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
title_sort Continuing versus suspending angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: Impact on adverse outcomes in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
author Lopes, Renato D.
author_facet Lopes, Renato D.
Macedo, Ariane Vieira Scarlatelli
Silva, Pedro Gabriel Melo de Barros e
Moll-Bernardes, Renata Junqueira
Feldman, Andre
D'Andréa Saba Arruda, Guilherme
Souza, Andrea Silvestre de
Albuquerque, Denilson Campos de
Mazza, Lilian
Santos, Mayara Fraga
Salvador, Natalia Zerbinatti
Gibson, C. Michael
Granger, Christopher B.
Alexander, John H.
Souza, Olga Ferreira de
author_role author
author2 Macedo, Ariane Vieira Scarlatelli
Silva, Pedro Gabriel Melo de Barros e
Moll-Bernardes, Renata Junqueira
Feldman, Andre
D'Andréa Saba Arruda, Guilherme
Souza, Andrea Silvestre de
Albuquerque, Denilson Campos de
Mazza, Lilian
Santos, Mayara Fraga
Salvador, Natalia Zerbinatti
Gibson, C. Michael
Granger, Christopher B.
Alexander, John H.
Souza, Olga Ferreira de
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Lopes, Renato D.
Macedo, Ariane Vieira Scarlatelli
Silva, Pedro Gabriel Melo de Barros e
Moll-Bernardes, Renata Junqueira
Feldman, Andre
D'Andréa Saba Arruda, Guilherme
Souza, Andrea Silvestre de
Albuquerque, Denilson Campos de
Mazza, Lilian
Santos, Mayara Fraga
Salvador, Natalia Zerbinatti
Gibson, C. Michael
Granger, Christopher B.
Alexander, John H.
Souza, Olga Ferreira de
dc.subject.en.pt_BR.fl_str_mv SARS-CoV-2
ACE Inhibitor
Angiotensin Receptor Blocker
Coronavirus
COVID-19
topic SARS-CoV-2
ACE Inhibitor
Angiotensin Receptor Blocker
Coronavirus
COVID-19
description Instituto D'Or de Pesquisa e Ensino. Rio de Janeiro, RJ, Brasil / Duke University Medical Center. Duke Clinical Research Institute. Durham, NC, USA / Brazilian Clinical Research Institute, São Paulo, SP, Brasil / Rede D'Or São Luiz, São Paulo, SP, Brasil.
publishDate 2020
dc.date.accessioned.fl_str_mv 2020-05-27T15:47:20Z
dc.date.available.fl_str_mv 2020-05-27T15:47:20Z
dc.date.issued.fl_str_mv 2020
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv LOPES, Renato D. et al. Continuing Versus Suspending Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers: Impact on Adverse Outcomes in Hospitalized Patients With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). American Heart Journal, p. 1-27, May 2020.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/41422
dc.identifier.issn.pt_BR.fl_str_mv 0002-8703
dc.identifier.doi.none.fl_str_mv 10.1016/j.ahj.2020.05.002
identifier_str_mv LOPES, Renato D. et al. Continuing Versus Suspending Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers: Impact on Adverse Outcomes in Hospitalized Patients With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). American Heart Journal, p. 1-27, May 2020.
0002-8703
10.1016/j.ahj.2020.05.002
url https://www.arca.fiocruz.br/handle/icict/41422
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
institution FIOCRUZ
reponame_str Repositório Institucional da FIOCRUZ (ARCA)
collection Repositório Institucional da FIOCRUZ (ARCA)
bitstream.url.fl_str_mv https://www.arca.fiocruz.br/bitstream/icict/41422/1/license.txt
https://www.arca.fiocruz.br/bitstream/icict/41422/2/1-s2.0-S0002870320301381-main.pdf
https://www.arca.fiocruz.br/bitstream/icict/41422/3/1-s2.0-S0002870320301381-main.pdf.txt
bitstream.checksum.fl_str_mv 70425d8cb6e40fdcf4edd2ef0660b45b
d3ed8514a186e1279ea1fb716e193c3f
e16baed2aee82134268d166c8467036c
bitstream.checksumAlgorithm.fl_str_mv MD5
MD5
MD5
repository.name.fl_str_mv Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)
repository.mail.fl_str_mv repositorio.arca@fiocruz.br
_version_ 1813009282674720768