Reducing Cardiovascular Risks During COVID-19 - Episode 9
Deepak Bhatt, MD, MPH: What other sorts of drugs, including things that are investigational, are you excited about in the COVID-19 [coronavirus disease 2019] space?
C. Michael Gibson, MS, MD: Right now, 1 of the things I’m excited about is the study that’s going on in Brazil called BRACE-CORONA. Renato Lopes is leading this. The question is this: Should we stop ACE inhibitors when people come in with COVID-19? There’s been concern that ACE inhibitors could accelerate the course of the disease. His team is doing the right thing. They’ve randomized about 700 patients to either continuation of ACE or discontinuation of ACE, and he’ll be presenting those results at ESC [European Society of Cardiology Congress] this year. We have a lot of observational data out there, but I have to congratulate Dr Renato Lopes on doing the right thing, which is a randomized trial to evaluate this question.
Deepak Bhatt, MD, MPH: I agree. It’s an important question since it was initially raised by some that it might be wise to stop ACE inhibitors and angiotensin receptor blockers. There is still some sentiment like that that lingers out there, so randomized data will be important. Certainly, I’d say that, until those randomized data are available, there’s no good reason to stop ACE inhibitors or angiotensin receptor blockers in patients who are on them and have good indications to be on them in the first place.
C. Michael Gibson, MS, MD: I’ve been disappointed by a lot of the IL-6 studies. I thought that was a nexus and that we would have a lot of success in shutting that down. That’s been disappointing. I’m excited by some of the observational data with some of the plasma infusions, but I’d like to see some randomized data there. I’m also anxious to see some of the monoclonal antibodies under development to see if they can be an effective treatment for the disease. Those are still getting underway.
Deepak Bhatt, MD, MPH: I would have expected some of the drugs that are already in use for cytokine storm and other situations, such as in the oncology world, might have been useful here.
C. Michael Gibson, MS, MD: Yeah.
Deepak Bhatt, MD, MPH: So far, nothing has panned out from that line of investigation looking at remdesivir or dexamethasone in terms of randomized clinical trial data supporting it. Who knows? Hopefully, there’ll be more to come.
Transcript Edited for Clarity