by Tonya L. Breaux-Shropshire, Ph.D., MPH, RN –
https://www.buzzsprout.com/765992/7086628
Does lisinopril prevent severe COVID-19 symptoms? This is a blog update on Lisinopril and the risk for severe Coronavirus (COVID-19) symptoms.
Lisinopril & COVID-19
As you know, blood pressure medication has been of concern in the news lately. Medical observations have noticed that patients with hypertension or other chronic diseases are at higher risk for severe COVID-19 symptoms. The most current evidence has shown that Ace inhibitor and angiotensin receptor blockers do not increase severe COVID-19 symptoms. See the video related to these new results here. Here is the most up to date treatment for COVID-19 which includes that vitamin D3 may be beneficial to prevent severe COVID-19 symptoms.
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Lisinopril & Risk of Severe COVID-19 Symptoms
Dr. Guptu, York Cardiology, tells you all about ACE inhibitors and why they are commonly used. Essentially, ACE inhibitors are given to control hypertension and to help prolong life. It has been thought that ACE inhibitors might cause severe COVID-19 systems. Dr. Guptu explains why he recommends continuing your prescribed medication. Overall, his recommendations are based on the uncertainty of the observation results and the benefits of the medication.
Dr. Joseph Vassalolli, MD, Chief Medical Officer, National Kidney Foundation, said in his Facebook Live Q & A, to stay the course. Dr. Vassalolli takes Ace inhibitors and recommends that you continue if you are doing well, and blood pressure is controlled. The benefit of these drugs outweighs the potential harm. If you get COVID-19, the medical team will decide the safety to continue the drug based on your case.
Angiotensin II Receptor Blockers Versus ACE inhibitors & COVID
ACE inhibitors and angiotensin-converting enzymes are prescribed mainly for patients with high blood pressure, particularly heart failure and diabetes. ACE inhibitors and angiotensin-converting enzymes work similarly to reduce blood pressure and prevent kidney damage and heart remodeling.
Lisinopril & Recent Tweets
Dr. David Moskowitz is conducting a study called the Master Viral Antidote trial. Between March 17 and March 22nd, he tweeted comments and several recommendations about ACE inhibitors and angiotensin II receptor blockers seen below (@dwmoskowitz, 2020).
Tweets
Mar 17
“Patient #1 of our #masterviralantidote trial: MS, 47 yr old, FL, given #ARB for the common cold (most likely diagnosis). Result: back to normal the next morning” (@dwmoskowitz,2020).
Mar 21
“Just got off the phone w/ Dr Reza Nejat. He used tiny doses of losartan to cure ppl of COVID19 ARDS: 6.25 mg twice a day. 12.5 mg/day is the dose I use for babies. He used it for full-grown adults. So losartan is clearly some kind of wonder-drug” (@dwmoskowitz, 2020).
Mar 22
“Latest thoughts:
1. Prevent getting sick w/an ARB or ACEI, especially if you’re already on one.
2. If you do get sick because this virus overwhelms your innate immune response + your lungs, consider switching to ramipril.
3. Combining losartan and ramipril might make sense” (@dwmoskowitz, 2020).
Mar 22
“COVID19 patient #1 in my clinical trial just agreed to try losartan. He got symptoms despite benazepril, an ACE inhibitor” (@dwmoskowitz, 2020).
Turns out Dino Prato NMD at Envita Med Ctr in Phoenix has been using inhaled quercetin since Feb. COVID19 patients who can’t breathe suddenly can. Between us we have hundreds of successes and no adverse events.
— dwmoskowitz (@dwmoskowitz) July 17, 2020
In early Feb I crushed likely Covid-19 with Elderberry syrup (quercetin and long tail of synergistic compounds) zinc amd Oil of Oregano 6drops per day, fever/fatigue gone in four days, sinuses worked another ten days.
— Robert Rand (@robertwrand) August 18, 2020
You can follow Dr. Moskowitz on Twitter for updates.
Updated Research Since March 30, 2020
Much more evidence is needed, but new research conducted by has been done that supports Dr. Moskowitz’s early findings. Dr. Moskowitz’s research initially found that Ace inhibitors and angiotensin II receptor blockers may be safe and even somewhat protective for COVID-19.
Lisinopril & Current Studies
According to the latest research done by Dr. Fabain Sanchis-Gomar and colleagues, Ace Inhibitors and ARBS should not be stopped. Sachis-Gomar et al. (2020) found no benefits nor harm in patients with COVID-19 and Ace Inhibitors or angiotensin II receptor blockers. Dr. Carl J. “Chip” Lavie talked with the host of DocWire and he summarized his paper.
Dr. Dietrich Klinghart, as SARS specialist, does not recommend ACE inhibitors, and he suggests that patients should ask their doctors to get off the ACE inhibitors. However, from his observations and experience, angiotensin II receptor blockers are “life-saving” and have prevented at least two patients from mechanical ventilation, as of March 2020.
As you know, doctors are looking for a treatment for COVID-19. Research has shown some repurposed drugs to be promising. Dr. Klinghart has prescribed Chloroquine and Zithromax since February. He prescribed 500 milligrams of hydroxychloroquine twice a day for ten days and usually, Zithromax 250 milligrams a day for ten days.
Updated April 30, 2020
The association between ACE inhibitors and COVID-19 severity is still unknown. Therefore, the recommendation is not to stop taking Ace inhibitors but don’t start as prophylaxis for COVID-19.
Conclusion
As of June 2020, more research is being conducted to determine the safety of Ace Inhibitors use during the COVID-19 pandemic. Some experts have supported the use of Ace inhibitors, and other experts have advised avoiding this class of drugs. However, just recently, angiotensin II receptor blockers have been shown to beneficial to a few patients. If you are doing well, perhaps a “watch and wait” approach might be the best. Consult with your health care provider if you have any problems or concerns. More to come!
Update
There was much uncertainty about ACE inhibitors or ARBs and COVID-19 and worsening of severe disease. Some experts were even saying that theses drugs might put you at risk to more likely catch COVID-19 if exposed.
So what do we know about ACE and ARBs as of May 2020? A large quality study has shown what some doctors had originally thought six months ago: people on “ACE inhibitor or ARB are at lower risk of COVID-19 and COVID-19 severity after considering many factors.
African Americans and non-whites still at higher risk for COVID-19 based on this new study. More studies need to be done to understand.
Meanwhile, read the Salt Fix that may help you understand the salt myth and how to eat salt safety. Click here to get the free audiobook!
Lower blood pressure using proven diet and lifestyle hacks. Click here to review.
Resources
Sanchis-Gomar, F., Lavie, C.J., Perez-Quilis, C., Henry, B. M., & Lippi, G. (2020, Mar. 30). Article in Press: Angiotensin-Converting Enzyme 2 and Antihypertensives (Angiotensin Receptor Blockers and Angiotensin-Converting Enzyme Inhibitors) in Coronavirus Disease 2019. Retrieved from https://www.mayoclinicproceedings.org/article/S0025-6196(20)30315-3/fulltext
Vassalolli, J. (2020).
Kuster, G. M., Pfister, O., Burkard, T., Zhou, Q., Twerenbold, R., Haaf, P., Widmer, A. F., & Osswald, S. (2020). SARS-CoV2: should inhibitors of the renin-angiotensin system be withdrawn in patients with COVID-19?. European heart journal, 41(19), 1801–1803. https://doi.org/10.1093/eurheartj/ehaa235
American Heart Association. (2020, Mar). Patients taking ACE-i and ARBs who contract COVID-19 should continue treatment, unless otherwise advised by their physician
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