Ongoing anti-hypertensive treatment doesn’t impact on outcome on medium-long term sequelae of patients with moderate to severe covid-19 pneumonia

Objective: One “hot” topic that remains to be elucidated is the possible role of anti-hypertensive drugs on middle and long term outcome of COVID-19 pneumonia. Namely, ACE2 receptor is highly expressed on the surface of cardiac and pulmonary cells, and it is used by coronaviruses, to enter host cells; specifically, the interaction between the “spike” protein of coronaviruses and ACE2 has been identified as a key factor for the virus transmission. This makes the role of ACE-inhibitors and Angiotensin Receptor Blockers (ARBs) drugs extremely controversial and their role – if any – is still to be elucidated. Moreover, it is still unclear whether these drugs may have any impact on SARS-CoV-2 sequelae. Design and method: In this retrospective study, we analysed a group of 70 hypertensive unvaccinated patients treated in our Medicine ward for moderate to severe COVID-19 pneumonia during pandemic who survived and accepted to undergo a follow-up visit after a mean of 260 days including phone interview, standard laboratory tests, chest x-ray and/or chest computed tomography, spirometry with evaluation of DLCO. Patients were divided in three groups according to hypertensive treatment: ACE-inhibitors (n. 27) or ARBs (n. 21) or other anti-hypertensive medication. The considered groups where homogeneous (see table) Results: As shown in the table, biochemical, radiological and respiratory data were not significantly different. Again, we did not find any significant difference in terms of number of non-specific radiological alterations (i.e. ground-glass opacities, irregular linear/reticular opacities), lung fibrosis, spirometry data, DLCO diffusion, persisting effort dyspnoea. Biochemical data were, once more, substantially super-imposable in the two groups Conclusions: In conclusion, in our study, we could not detect any difference in middle-long term outcome nor in complication type or number in the groups of hypertensive patients undergoing different treatments. This result seems to support and to strengthen the idea that ACE-inhibitors and ARBs do not play a significant role on onset, evolution and middle-long term outcome of moderate to severe COVID-19 pneumoniae: although the number of follow-up patients is very small, we did not find any difference in sequelae in both groups.