The dynamics of hypertension and renal function in CKD and non-CKD patients affected with COVID-19 – final results of BIRCOV trial

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dc.contributor.authorIvanov, Dmytro
dc.contributor.authorGozhenko, Antolii
dc.contributor.authorIvanova, Mariia
dc.contributor.authorZavalna, Iryna
dc.contributor.authorCrestanello, Tommy
dc.date.accessioned2023-06-28T12:13:08Z
dc.date.available2023-06-28T12:13:08Z
dc.date.issued2023-06
dc.descriptionLocal ethic commission (21.02.2020 No1) and Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine (24.04.2020 No16) approved the study.
dc.description.abstractIntroduction and aim. There is evidence in the literature about a change in the effectiveness of inhibitors of the renin-angiotensin system (iRAS) in people with COVID-19. Considering different mechanisms of pressure reduction by different iRAS groups, one can expect differences in people with COVID-19 receiving these drugs. The aim of angiotensin-converting enzyme inhibitors (ACEi), angiotensin II receptor blockers (ARB) and direct renin inhibitors (DRi) usage in COVID-19 (BIRCOV study) was to pinpoint clinical and laboratory differences in people with hypertension who received iRAS and suffered coronavirus infection. Material and methods. An open prospective trial of 108 patients was performed in subjects suffering from COVID-19 who have been receiving iRAS: ACEi, ARB or DRi as basic antihypertensive therapy. The disease follow-up was 12 and 24 weeks. A blood pressure (BP) measurement was performed the week before COVID-19 and up to 24 weeks from the disease onset. Subanalysis in patients with chronic kidney disease (CKD) was performed. Results. In patients with COVID-19, a change in the effectiveness of antihypertensive therapy depending on the type of drug in the iRAS group has been documented in the first 4 weeks from the onset of the disease. The use of ACEi had significantly increased the risk of severe hypotension, unlike ARBs that do not cause hypotension. The synchronous decline of estimated glomerular filtration rate (eGFR) and systolic BP was more pronounced in CKD patients followed by albuminuria incidence. The greatest decrease in eGFR was in people taking ACEi. Conclusion. People with grade 1-2 hypertension who are constantly receiving RAS inhibitors suffering from COVID-19 may develop hypotension with ACEi. COVID-19 leads to transient albuminuria and decreased glomerular filtration rate, which is especially dangerous for people with CKD 4-5.eng
dc.description.sponsorshipStudy was funded by prof. D. Ivanov Medical Practice.
dc.identifier.citationEuropean Journal of Clinical and Experimental Medicine T. 21, z. 2 (2023), s. 230-238
dc.identifier.doi10.15584/ejcem.2023.2.3
dc.identifier.eissn2544-1361
dc.identifier.urihttps://repozytorium.ur.edu.pl/handle/item/9140
dc.language.isoeng
dc.publisherPublishing Office of the University of Rzeszow
dc.rightsAttribution-NonCommercial-NoDerivs 3.0 Poland*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/3.0/pl/*
dc.subjectACEi
dc.subjectARB
dc.subjectBIRCOV trial
dc.subjectCOVID-19
dc.subjectDRi
dc.subjectiRAS
dc.titleThe dynamics of hypertension and renal function in CKD and non-CKD patients affected with COVID-19 – final results of BIRCOV trial
dc.typearticle
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European Journal of Clinical and Experimental Medicine T.21, z. 2 (2023)