Infectious Disease

COVID-19 Roundup: ACE/ARB, Retired Physician Guidance, Ocular Symptoms

ACE Inhibitors and ARBs

Although previous research has suggested that may worsen outcomes in patients with COVID-19, the authors of a special report, published in the New England Journal of Medicine, wrote that “insufficient data are available to determine whether these observations readily translate to humans, and no studies have evaluated the effects of renin–angiotensin–aldosterone system (RAAS) inhibitors in COVID-19.”

They argue that discontinuing treatment with either angiotensin-converting enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs) in high-risk patients could result in clinical instability and adverse outcomes, and that “until further data are available, we think that RAAS inhibitors should be continued in patients in otherwise stable condition who are at risk for, being evaluated for, or with COVID-19.”

Retired Physician Guidelines

The American Medical Association has released a guide for retired physicians who are considering returning to work during the COVID-19 outbreak.

The guide features sections on license considerations, ways to provide assistance aside from patient care, the re-entering of practice, professional liability, retirement status, role clarifications, and a list of COVID-19 resources.

Ocular Findings

One-third of patients with COVID-19 in Hubei, China, had ocular abnormalities, according to a study recently published in JAMA Ophthalmology.

The authors examined data from 38 patients with confirmed COVID-19, 12 of whom had ocular manifestations that were consistent with conjunctivitis. Those with ocular symptoms were found to be more likely to have higher white blood cell and neutrophil counts and higher levels of procalcitonin, C-reactive protein, and lactate dehydrogenase than patients without ocular symptoms.


References:

  1. Vaduganathan M, Vardeny O, Michel T, et al. Renin–angiotensin–aldosterone system inhibitors in patients with Covid-19 [published online March 30]. N Engl J Med. doi:10.1056/NEJMsr2005760
  2. Senior physician COVID-19 resource guide. American Medical Association. Published March 30, 2020. Accessed March 31, 2020. https://www.ama-assn.org/delivering-care/public-health/senior-physician-covid-19-resource-guide
  3. Wu P, Duan F, Luo C, et al. Characteristics of ocular findings of patients with coronavirus disease 2019 (COVID-19) in Hubei Province, China [published online March 31, 2020]. JAMA Ophthalmol. doi:10.1001/jamaophthalmol.2020.1291