COVID: ACE2, more info


Jon Pincus just sent me this really helpful link: http://www.nephjc.com/news/covidace2

It has lots more info on the actual virology involved, does come to some of the same conclusions that I did (the studies are really mixed, often involve just animals, so hard to be anything like really convincing). And it does cite pretty much all of the cardiol/med societies coming out against changes in ACE/ARB prescribing

So, after further reflection on this murky turf, in some cases I would consider stopping those meds that could possibly make COVID clinically worse. and hopefully that will be a transient interruption, til we get thru the current pandemic….
--seems reasonable to avoid NSAIDs, unless really necessary (and many people do just fine with acetaminophen)
--only really stop ACE/ARB in those patients who had only mild indications (mildly high BP, or proteinuria <300-500 mg/mg).
    --I am somewhat concerned with changing BP meds in those with higher BP, since we might well need to monitor the response and labs associated for many patients (at least many of mine who are not able to monitor their own blood pressure accurately)

geoff

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