Popular blood pressure medicines do not put patients at greater COVID-19 risk, new study finds

A nurse takes a nasal swab sample to test for COVID-19 at a mobile testing station in a public school parking area in Compton, California. (AFP File Photo)
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Updated 13 June 2020

Popular blood pressure medicines do not put patients at greater COVID-19 risk, new study finds

  • The authors recommended that patients should not discontinue their treatment to avoid the virus

NEW YORK: New research offers reassuring evidence to hundreds of millions of people with high blood pressure that popular anti-hypertension drugs do not put them at greater risk from COVID-19 as some experts had feared.
Two blood pressure-lowering drug classes, called ACE inhibitors and ARBs, came under scrutiny after the US Centers for Disease Control and Prevention reported in April that 72% of hospitalized COVID-19 patients 65 or older had hypertension.
ACE inhibitors and ARBs are thought to trigger activity along the same biological pathways used by the COVID-19 novel coronavirus to attack the lungs.
Researchers at Oxford University had recommended some patients stop the drugs until the risks were better known, while others argued patients should stay on the medications. An expert at the Johns Hopkins Center for Drug Safety and Effectiveness in Baltimore described the debate as “one of the most important clinical questions.”
The new study made publicly available on Friday found no clinically significant increased risk of either a diagnosis or hospitalization of COVID-19 with ACE or ARB use compared with other first-line drug treatments for hypertension.
The authors recommended that patients should not discontinue their treatment to avoid the virus, which has infected over 7.5 million people worldwide and killed more than 420,000.
“Our findings are quite reassuring,” said Marc Suchard, a biostatistician at the University of California, Los Angeles, who co-led the study. “Taking an ACE or an ARB is just as safe as other first-list hypertension agents in terms of your risk of contracting COVID-19.”
The study analyzed the electronic medical records of 1.1 million patients on anti-hypertension drugs from the United States and Spain and has not yet been peer reviewed.
It was part of the Observational Health Data Sciences and Informatics program (OHDSI, pronounced Odyssey) response to COVID-19, in collaboration with the US Department of Veterans Affairs, Columbia University Irving Medical Center, and SIDIAP, a Spanish health research organization.
OHDSI is an open-source collaborative research platform that conducts large-scale studies.
The findings join a growing body of evidence showing that the life-saving drugs neither increase nor reduce the risk of contracting COVID-19 or developing a severe case of the virus.
Harmony R. Reynolds, a cardiologist at New York University Grossman School of Medicine and the lead author of a study published last month in The New England Journal of Medicine, said she had been besieged by calls from worried patients.
With little research to go on, she advised them to stay on the drugs and embarked on a study with colleagues to analyze the medical records of over 12,000 COVID-19 patients at NYU’s Langone Health system. They found that those using ACE inhibitors or ARBs were no more likely to test positive than those who were not, nor was their risk of severe illness higher. The same held true for other classes of drugs — beta-blockers, calcium channel blockers and thiazide diuretics.
Separate studies of more than 12,000 patients in Spain and more than 30,000 health system beneficiaries in Italy reached similar conclusions. They were published last month in The Lancet and the New England Journal, respectively.
Another study in the New England Journal in May reported no increased risk of hospital deaths associated with ACE inhibitors. Both that study and another on hydroxychloroquine were retracted earlier this month after the co-authors said they could no longer vouch for the validity of the data they obtained from Surgisphere, a private medical record firm, however.


When coronavirus robs you of your sense of smell

Updated 2 min 56 sec ago

When coronavirus robs you of your sense of smell

  • “Anosmia cuts you off from the smells of life, it’s a torture.” — Jean-Michel Maillard, president of anosmie.org
PARIS: “What I miss most is the smell of my son when I kiss him, the smell of my wife’s body,” says Jean-Michel Maillard.
Anosmia — the loss of one’s sense of smell — may be an invisible handicap, but is psychologically difficult to live with and has no real treatment, he says.
And it is the price that an increasing number of people are paying after surviving a brush with the coronavirus, with some facing a seemingly long-term inability to smell.
“Anosmia cuts you off from the smells of life, it’s a torture,” says Maillard, president of anosmie.org, a French group designed to help sufferers.
If you have the condition you can no longer breathe in the smell of your first morning coffee, smell the cut grass of a freshly mown lawn or even “the reassuring smell of soap on your skin when you’re preparing for a meeting,” he says.
You only truly become aware of your sense of smell when you lose it, says Maillard, who lost his own following an accident.
And it is not just the olfactory pleasures you lose. He points out that people with anosmia are unable to smell smoke from a fire, gas from a leak, or a poorly washed dustbin.
Eating is a completely different experience too, as so much of what we appreciate in food is what we can smell, says Alain Corre, an ear, nose and throat specialist at the Hopital-Fondation Rothschild in Paris.
“There are dozens of causes of anosmia,” he says, including nasal polyps, chronic rhinitis, diabetes, Alzheimer’s and Parkinson’s.
Now the new coronavirus has been added to that list, says Corre — with the symptom alone allowing a diagnosis of COVID-19 in some cases.
“When people lose their sense of smell and don’t get it back, we note a real change in the quality of life and a level of depression that is not insignificant,” he adds.
The problem is when the condition persists, he says.
“To be deprived of your sense of smell for a month, it’s not serious,” says Maillard. “Two months, it starts to become a problem. But after six months, you’re all alone under a bell jar.
“There’s a psychological aspect to this which is very difficult to live with,” he insists. “You need to get help.”

CovidORL study
There is no specific treatment for the condition.
You have to address the cause, says Corre, but “the problem of the anosmias linked to the virus is that often, the treatment of the viral infection has no effect on your smell.
“According to the first numbers, around 80 percent of patients suffering from COVID-19 recover spontaneously in less than a month and often even faster, in eight to 10 days.”
For others, however, it could be that the disease has destroyed their olfactory neurons — the ones that detect smells. The good news is that these neurons, at the back of the nose, are able to regenerate.
Two Paris hospitals, Rothschild and Lariboisiere, have launched a “CovidORL” study to investigate the phenomenon, testing how well different nose washes can cure anosmia.
One cortisone-based treatment has proved effective in treating post-cold instances of anosmia and offers some hope, says Corre.
Another way to approach the condition is through olfactory re-education, to try to stimulate the associations that specific smells have in your memory, he says.
His advice is to choose five smells in your kitchen that are special to you, that you really like: cinnamon say, or thyme. Breathe them in twice a day for five to 10 minutes while looking at what it is you are inhaling.
Anosmie.org has even put together a re-education program using essential oils, working with Hirac Gurden, director of neuroscience research at the National Center for Scientific Research (CNRS). It is based on the work of Dresden-based researcher Thomas Hummel.
“As early as March, we got several hundred phone calls, emails from people who had COVID and who were calling for help because they couldn’t smell anything any more,” says Gurden.
Maillard meanwhile finished his re-education program last winter, using four smells.
“Today, I have 10 of them,” he says, including fish, cigarettes and rose essential oil. “I’ve even found a perfume that I can smell!” he declares.