Protecting older patients with cardiovascular diseases from COVID-19 complications using current medications.
Antiarrhytmic
Anticoaculant
Aspirin
COVID-19
Colchicine
Diabetes
NSAID
RAAS
Statin
Vitamin D
Journal
European geriatric medicine
ISSN: 1878-7649
Titre abrégé: Eur Geriatr Med
Pays: Switzerland
ID NLM: 101533694
Informations de publication
Date de publication:
08 2021
08 2021
Historique:
received:
20
02
2021
accepted:
15
04
2021
pubmed:
26
5
2021
medline:
7
8
2021
entrez:
25
5
2021
Statut:
ppublish
Résumé
In the pathogenesis of severe COVID-19 complications, derangements of renin-angiotensin-aldosterone system (RAAS), vascular endothelial dysfunction leading to inflammation and coagulopathy, and arrhythmias play an important role. Therefore, it is worth considering the use of currently available drugs to protect COVID-19 patients with cardiovascular diseases. We review the current experience of conventional cardiovascular drugs [angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers, anticoagulants, acetosalicylic acid, antiarrhythmic drugs, statins] as well as some other drug classes (antidiabetic drugs, vitamin D and NSAIDs) frequently used by older patients with cardiovascular diseases. Data were sought from clinical databases for COVID-19 and appropriate key words. Conclusions and recommendations are based on a consensus among all authors. Several cardiovascular drugs have a potential to protect patients with COVID-19, although evidence is largely based on retrospective, observational studies. Despite propensity score adjustments used in many analyses observational studies are not equivalent to randomised controlled trials (RCTs). Ongoing RCTs include treatment with antithrombotics, pulmonary vasodilators, RAAS-related drugs, and colchicine. RCTs in the acute phase of COVID-19 may not, however, recognise the benefits of long term anti-atherogenic therapies, such as statins. Most current cardiovascular drugs can be safely continued during COVID-19. Some drug classes may even be protective. Age-specific data are scarce, though, and conditions which are common in older patients (frailty, comorbidities, polypharmacy) must be individually considered for each drug group.
Identifiants
pubmed: 34031865
doi: 10.1007/s41999-021-00504-5
pii: 10.1007/s41999-021-00504-5
pmc: PMC8143992
doi:
Substances chimiques
Angiotensin Receptor Antagonists
0
Angiotensin-Converting Enzyme Inhibitors
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
725-739Investigateurs
None Grodzicki
None Strandberg
Informations de copyright
© 2021. The Author(s).
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