{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:48:38Z","timestamp":1753890518980,"version":"3.41.2"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,8,19]],"date-time":"2021-08-19T00:00:00Z","timestamp":1629331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p><jats:bold>Objectives:<\/jats:bold> To evaluate the impact of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) on the inflammatory response and viral clearance in coronavirus disease 2019 (COVID-19) patients.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> We included 229 patients with confirmed COVID-19 in a multicenter, retrospective cohort study. Propensity score matching at a ratio of 1:3 was introduced to eliminate potential confounders. Patients were assigned to the ACEI\/ARB group (<jats:italic>n<\/jats:italic> = 38) or control group (<jats:italic>n<\/jats:italic> = 114) according to whether they were current users of medication.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Compared to the control group, patients in the ACEI\/ARB group had lower levels of plasma IL-1\u03b2 [(6.20 \u00b1 0.38) vs. (9.30 \u00b1 0.31) pg\/ml, <jats:italic>P<\/jats:italic> = 0.020], IL-6 [(31.86 \u00b1 4.07) vs. (48.47 \u00b1 3.11) pg\/ml, <jats:italic>P<\/jats:italic> = 0.041], IL-8 [(34.66 \u00b1 1.90) vs. (47.93 \u00b1 1.21) pg\/ml, <jats:italic>P<\/jats:italic> = 0.027], and TNF-\u03b1 [(6.11 \u00b1 0.88) vs. (12.73 \u00b1 0.26) pg\/ml, <jats:italic>P<\/jats:italic> &amp;lt; 0.01]. Current users of ACEIs\/ARBs seemed to have a higher rate of vasoconstrictive agents (20 vs. 6%, <jats:italic>P<\/jats:italic> &amp;lt; 0.01) than the control group. Decreased lymphocyte counts [(0.76 \u00b1 0.31) vs. (1.01 \u00b1 0.45)<jats:sup>*<\/jats:sup>10<jats:sup>9<\/jats:sup>\/L, <jats:italic>P<\/jats:italic> = 0.027] and elevated plasma levels of IL-10 [(9.91 \u00b1 0.42) vs. (5.26 \u00b1 0.21) pg\/ml, <jats:italic>P<\/jats:italic> = 0.012] were also important discoveries in the ACEI\/ARB group. Patients in the ACEI\/ARB group had a prolonged duration of viral shedding [(24 \u00b1 5) vs. (18 \u00b1 5) days, <jats:italic>P<\/jats:italic> = 0.034] and increased length of hospitalization [(24 \u00b1 11) vs. (15 \u00b1 7) days, <jats:italic>P<\/jats:italic> &amp;lt; 0.01]. These trends were similar in patients with hypertension.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> Our findings did not provide evidence for a significant association between ACEI\/ARB treatment and COVID-19 mortality. ACEIs\/ARBs might decrease proinflammatory cytokines, but antiviral treatment should be enforced, and hemodynamics should be monitored closely. Since the limited influence on the ACEI\/ARB treatment, they should not be withdrawn if there was no formal contraindication.<\/jats:p>","DOI":"10.3389\/fcvm.2021.710946","type":"journal-article","created":{"date-parts":[[2021,8,19]],"date-time":"2021-08-19T09:54:33Z","timestamp":1629366873000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Impact of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers on the Inflammatory Response and Viral Clearance in COVID-19 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