A study carried out by the D’Or Research and Teaching Institute and the Brazilian Clinical Research Institute (BCRI) points out that suspending treatments with angiotensin converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (BRAs) does not have any impact on the evolution of covid-19 conditions. Medications are usually used by hypertensive and cardiac patients.
According to doctors and researchers involved, there is no indication that these people should stop their treatments if they are infected with the new coronavirus.
Since the beginning of the pandemic, medical entities have expressed concern about the evolution of covid-19 in patients with heart disease. There was a fear that the use of these drugs could aggravate the disease. The research results, however, did not validate this hypothesis.
Founded in 2010 by the hospital group Rede D’Or, the D’Or Institute for Research and Education conducts research that has a direct clinical impact in the short term. BCRI is an academic research group affiliated with the Federal University of São Paulo (Unifesp). According to the two institutions, the partnership resulted in the first randomized study that evaluated the consequences of using ACE inhibitors and ARBs during covid-19 infection.
“We have shown that there is no benefit in stopping these drugs. The study gives a definitive answer to an attitude that many doctors adopted in the beginning of the pandemic, when they suspended the use of these drugs for fear that they could worsen the covid-19 ”, said doctor Renato Lopes, professor at Unifesp and Duke University , an institution based in the state of North Carolina, in the United States.
Two groups of patients were compared. In one, the use of medications was suspended for 30 days. In the other group, treatments followed normally. The researchers evaluated several indicators such as the average length of hospital stay and discharge, the need for a respirator, the frequency of occurrences of cardiac complications and renal failure and the causes of mortality.
There were no relevant differences between the strategy to stop the drug or continue its use. In view of the conclusions, Lopes advises that hypertensive patients and patients with other heart diseases do not suspend the medication. “These drugs protect the heart and reduce the risk of heart attack, stroke and thrombosis. As we have seen, they can be continued even in the presence of covid-19. ”
The work was done over five months and presented two weeks ago at the European Congress of Cardiology. The event, held in a online, had more than 110 thousand specialists registered from more than 200 countries. “Of the 12 studies selected for the noblest session of the congress, this was the only one in Latin America”, noted Renato.
The research analyzed 659 patients treated in 29 Rede D’Or hospitals in different parts of Brazil. Research participants were over 18 years old and had different severity levels of the disease, from mild to severe. According to the researchers, the results can be applied to the population in general, since the sample of patients was quite diverse and heterogeneous. “There is no other similar study in the world with this number of participants. It is an extremely representative population ”, said the doctor.
According to Olga Ferreira, national director of the Cardiology and Arrhythmia Service of Rede D’Or São Luiz, the study’s conclusions should be disseminated both among physicians and among the general population. “Many patients were suspending their medications even on their own and exposing themselves to the risk of a hypertensive crisis or a bigger problem. We can now assure these patients that they do not need to stop the medication. ”
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