Impact of the Angiotensin-Converting Enzyme (ACE) Inhibitors on the Course of the Acute Respiratory Distress Syndrome (ARDS) Developed During COVID-19 and Other Severe Respiratory Infections Under Hyperferritinemia Conditions: A Cohort Study.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2023-01-01 DOI:10.1177/11795484231180391

Magda Rurua, Elena Pachkoria, Tamar Sanikidze, K Machvariani, George Ormocadze, Tinatin Jomidava, Diana Dzidziguri, Levan Ratiani

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Abstract

Background: Angiotensin-converting enzyme 2 (ACE2) is not only the entry route of SARS-CoV-2 infection but also triggers a major mechanism of COVID-19 aggravation by promoting a hyperinflammatory state, leading to lung injury, hematological and immunological dysregulation. The impact of ACE2 inhibitors on the course of COVID-19 is still unclear. The effect of ACE2 inhibitors on the course of acute respiratory distress syndrome (ARDS) during COVID-19 and other severe respiratory infections in conditions of hyperferritinemia (HF) was investigated.

Methods: A cohort study of critically ill patients with COVID-19 and other respiratory diseases (widespread infection, pneumonia) who underwent treatment in The Critical Care Unit of the First University Clinic (Tbilisi, Georgia) during the 2020-2021 years was conducted. The impact of the ACE2 inhibitors on the course of the ARDS developed during COVID-19 and other severe respiratory infections in conditions of different severity of HF was evaluated.

Results: In COVID-19-infected (I) and uninfected (II) patients with ARDS, ACE2 inhibitors reduce the levels of Ang II, C reactive protein (CRP) and D-dimer (I: from 1508.07 ± 26.68 to 48.51 ± 24.35, from 233.92 ± 13.02 to 198.12 ± 11.88, from 7.88 ± 0.47 to 6.28 ± 0.43; II: from 1000.14 ± 149.49 to 46.23 ± 88.21, 226.48 ± 13.81 to 183.52 ± 17.32, from 6.39 ± 0.58 to 5.48 ± 0.69) at moderate HF and Ang II, CRP levels (I: from 1845.89 ± 89.37 to 49.64 ± 51.05, from 209.28 ± 14.41 to 175.37 ± 9.84; II: from 1753.29 ± 65.95 to 49.76 ± 55.74, 287.10 ± 20.50 to 214.71 ± 17.32) at severe HF, reduce interleukin-6 (IL-6) expression at moderate HF (I: from 1977.23 ± 354.66 to 899.36 ± 323.76) and cause reduction of pCO₂ index at severe HF (I: from 69.80 ± 3.22 to 60.44 ± 2.20) in COVID-19-infected patients.

Conclusion: Study results show that the ACE2 inhibitors play an important role in the regulation of inflammatory processes in both COVID-19-infected and uninfected patients with ARDS. ACE2 inhibitors decrease immunological disorders, inflammation, and lung alveoli dysfunction, especially in COVID-19-infected patients.

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血管紧张素转换酶(ACE)抑制剂对COVID-19和其他严重呼吸道感染在高铁素血症条件下发生的急性呼吸窘迫综合征(ARDS)病程的影响:一项队列研究

背景:血管紧张素转换酶2 (angiotentin -converting enzyme, ACE2)不仅是SARS-CoV-2感染的进入途径，而且通过促进高炎症状态，导致肺损伤、血液学和免疫学失调，是引发COVID-19加重的重要机制。ACE2抑制剂对COVID-19病程的影响尚不清楚。探讨ACE2抑制剂对COVID-19及其他严重呼吸道感染患者高铁蛋白血症(HF)急性呼吸窘迫综合征(ARDS)病程的影响。方法:对2020-2021年在格鲁吉亚第比利斯第一大学诊所重症监护病房接受治疗的COVID-19合并其他呼吸道疾病(广泛感染、肺炎)危重患者进行队列研究。评估ACE2抑制剂对不同严重程度HF患者在COVID-19和其他严重呼吸道感染期间发生的ARDS病程的影响。结果:在covid -19感染(I)和未感染(II) ARDS患者中，ACE2抑制剂可降低Ang II、C反应蛋白(CRP)和d -二聚体(I)水平:从1508.07±26.68降至48.51±24.35，从233.92±13.02降至198.12±11.88，从7.88±0.47降至6.28±0.43;二:从1000.14±149.49,46.23±88.21,226.48±13.81,183.52±17.32,6.39±0.58,5.48±0.69)在温和的高频和Angⅱ,c反应蛋白水平(我:从1845.89±89.37,49.64±51.05,209.28±14.41,175.37±9.84;重症HF患者II值从1753.29±65.95降至49.76±55.74,287.10±20.50降至214.71±17.32)，中度HF患者IL-6 (IL-6)表达降低(I值从1977.23±354.66降至899.36±323.76)，重症HF患者pCO2指数降低(I值从69.80±3.22降至60.44±2.20)。结论:研究结果表明，ACE2抑制剂在covid -19感染和未感染ARDS患者的炎症过程中发挥重要作用。ACE2抑制剂可减少免疫紊乱、炎症和肺泡功能障碍，特别是在covid -19感染患者中。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.