ArticleAmerican heart journal2020
Continuing versus suspending angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: Impact on adverse outcomes in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)--The BRACE CORONA Trial.
Article in American heart journal, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 89 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
89 citing papers in PubMed, 4 syntheses or guidelines pooled it, 144 citations in OpenAlex.
- The Interplay Between the Immune System, the Renin-Angiotensin-Aldosterone System (RAAS), and RAAS Inhibitors May Modulate the Outcome of COVID-19: A Systematic Review.Journal of clinical pharmacology · 2021Pooled it
- Pooled it
- Associations Between the Use of Renin-Angiotensin System Inhibitors and the Risks of Severe COVID-19 and Mortality in COVID-19 Patients With Hypertension: A Meta-Analysis of Observational Studies.Frontiers in cardiovascular medicine · 2021Pooled it
- Publications and retracted articles of COVID-19 pharmacotherapy-related research: A systematic review.Science progressPooled it
- Discontinuing vs continuing ACEIs and ARBs in hospitalized patients with COVID-19 according to disease severity: Insights from the BRACE CORONA trial.American heart journal · 2022Trial
- Trial
- The Relation of Angiotensin-Converting Enzyme 2, Renin-Angiotensin-Aldosterone System Inhibitors, and Arterial Stiffness in Acute COVID-19 Emergency Department Patients-A Prospective Observational Study.Journal of clinical medicine · 2025Article
- Treat or not treat COVID-19 with combined renin-angiotensin system and neprilysin inhibition: Have we found a solution?European journal of heart failure · 2025Article
- Impact of Hypertension and Antihypertensive Treatment on COVID-19 Severity: A Retrospective Observational Study in Ternopil Region, Ukraine.Therapeutics and clinical risk management · 2025Article
- The association between the use of angiotensin-converting enzyme inhibitors /angiotensin receptor blockers and the development of ventilator-associated pneumonia in the intensive care unit: a retrospective cohort study.BMC pulmonary medicine · 2024Article
- Perioperative cardiovascular risk and preventions of patients with post-COVID-19 condition.Heliyon · 2024Review
- Post COVID-19 complications and follow up biomarkers.Nanoscale advances · 2023Review
- New Insights on the Mechanisms of Myocardial Injury in Hypertensive Patients With COVID-19.Journal of clinical immunology · 2023Article
- Review
- Clinical outcomes in COVID-19 among patients with hypertension in the Philippine CORONA Study.European journal of medical research · 2023Article
- Troponin in COVID-19: To Measure or Not to Measure? Insights from a Prospective Cohort Study.Journal of clinical medicine · 2022Article
- Global representation of heart failure clinical trial leaders, collaborators, and enrolled participants: a bibliometric review 2000-20.European heart journal. Quality of care & clinical outcomes · 2022Article
- Diminazene Aceturate Reduces Angiotensin II Constriction and Interacts with the Spike Protein of Severe Acute Respiratory Syndrome Coronavirus 2.Biomedicines · 2022Article
- NKG2A Expression among CD8 Cells Is Associated with COVID-19 Progression in Hypertensive Patients: Insights from the BRACE CORONA Randomized Trial.Journal of clinical medicine · 2022Article
- An insight into SARS-CoV-2 structure, pathogenesis, target hunting for drug development and vaccine initiatives.RSC medicinal chemistry · 2022Review
29 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Angiotensin-converting enzyme-2 (ACE2) expression may increase due to upregulation in patients using angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARBs). Because renin-angiotensin system blockers increase levels of ACE2, a protein that facilitates coronavirus entry into cells, there is concern that these drugs could increase the risk of developing a severe and fatal form of COVID-19. The impact of discontinuing ACEI and ARBs in patients with COVID-19 remains uncertain.
designBRACE CORONA is a pragmatic, multicenter, randomized, phase IV, clinical trial that aims to enroll around 500 participants at 34 sites in Brazil. Participants will be identified from an ongoing national registry of suspected and confirmed cases of COVID-19. Eligible patients using renin-angiotensin system blockers (ACEI/ARBs) with a confirmed diagnosis of COVID-19 will be randomized to a strategy of continued ACEI/ARB treatment versus temporary discontinuation for 30 days. The primary outcome is the median days alive and out of the hospital at 30 days. Secondary outcomes include progression of COVID-19 disease, all-cause mortality, death from cardiovascular causes, myocardial infarction, stroke, transient ischemic attack, new or worsening heart failure, myocarditis, pericarditis, arrhythmias, thromboembolic events, hypertensive crisis, respiratory failure, hemodynamic decompensation, sepsis, renal failure, and troponin, B-type natriuretic peptide (BNP), N-terminal-proBNP, and D-dimer levels. SUMMARY: BRACE CORONA will evaluate whether the strategy of continued ACEI/ARB therapy compared with temporary discontinuation of these drugs impacts clinical outcomes among patients with COVID-19.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.