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Protecting older patients with cardiovascular diseases from COVID-19 complications using current medications

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posted on 2023-06-10, 00:35 authored by Mariana Alves, Marília Andreia Fernandes, Gülistan Bahat, Athanase Benetos, Hugo Clemente, Tomasz Grodzicki, Manuel Martínez-Sellés, Francesco Mattace-Raso, Chakravarthi RajkumarChakravarthi Rajkumar, Andrea Ungar, Nikos Werner, Timo E Strandberg, EuGMS Special Interest Group inCardiovascular Medicine
Purpose In the pathogenesis of severe COVID-19 complications, derangements of renin–angiotensin–aldosterone system (RAAS), vascular endothelial dysfunction leading to inflammation and coagulopathy, and arrhythmias play an important role. Therefore, it is worth considering the use of currently available drugs to protect COVID-19 patients with cardiovascular diseases. Methods We review the current experience of conventional cardiovascular drugs [angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers, anticoagulants, acetosalicylic acid, antiarrhythmic drugs, statins] as well as some other drug classes (antidiabetic drugs, vitamin D and NSAIDs) frequently used by older patients with cardiovascular diseases. Data were sought from clinical databases for COVID-19 and appropriate key words. Conclusions and recommendations are based on a consensus among all authors. Results Several cardiovascular drugs have a potential to protect patients with COVID-19, although evidence is largely based on retrospective, observational studies. Despite propensity score adjustments used in many analyses observational studies are not equivalent to randomised controlled trials (RCTs). Ongoing RCTs include treatment with antithrombotics, pulmonary vasodilators, RAAS-related drugs, and colchicine. RCTs in the acute phase of COVID-19 may not, however, recognise the benefits of long term anti-atherogenic therapies, such as statins. Conclusions Most current cardiovascular drugs can be safely continued during COVID-19. Some drug classes may even be protective. Age-specific data are scarce, though, and conditions which are common in older patients (frailty, comorbidities, polypharmacy) must be individually considered for each drug group.

History

Publication status

  • Published

File Version

  • Published version

Journal

European Geriatric Medicine

ISSN

1878-7649

Publisher

Springer

Issue

4

Volume

12

Page range

725-739

Event location

Switzerland

Department affiliated with

  • Clinical and Experimental Medicine Publications

Full text available

  • Yes

Peer reviewed?

  • Yes

Legacy Posted Date

2021-08-10

First Open Access (FOA) Date

2021-08-10

First Compliant Deposit (FCD) Date

2021-08-10

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