Does Losartan reduce the severity of COVID-19 in hypertensive patients?
Mohammadreza Mirjalili, Moslem Taheri Soodejani, Mehdi Raadabadi, Ali Dehghani, Fateme Salemi
BMC Cardiovascular Disorders, doi:10.1186/s12872-022-02548-2
Background: One of the global problems is to control the coronavirus epidemic, and the role of different medicines is still unknown to policymakers. This study was conducted to evaluate the effects of losartan on the mortality rate of COVID-19 in hypertensive patients.
Methods: The research sample of analytical study included 1458 patients presenting to COVID-19 diagnostic centers in Yazd that were examined in the first six months of 2020. Data were analyzed using descriptive statistics as well as chi-square, Fisher's exact test, t test, and logistic regression. Results: Of 1458 subjects that were studied, 280 were hypertensive of whom 179 tested positive for SARS-CoV-2 PCR. The results showed a lower chance of death by more than 5 times in hypertensive patients who used losartan (P = 0.003). Moreover, regarding the effect of losartan on the prevention of COVID-19 in hypertensive patients, it was found that this medicine played a protective role although this relationship was not statistically significant (P = 0.86).
Conclusions: The results showed that losartan reduced the chance of mortality in hypertensive patients. It is recommended that the effect of losartan and other blood pressure medicines on COVID-19 patients be investigated in larger studies as well as laboratory investigations.
Authors' contributions MM and AD have designed the study and supervised the thesis. MR collected the data and analyzed it. They also prepared the first draft of the manuscript. MTS has edited and finalized the manuscript. All authors read the manuscript and approved it.
Declarations
Ethics approval and consent to participate The article's proposal was approved by the ethics committee of Shahid Sadoughi University of Medical Sciences with the ID of IR.SSU.REC.1399.101. Due to the retrospective nature of the study, no study specific consent form was used. However, patients admitted to our hospital are asked to sign a general consent upon admission, which covers the collection of patient data and publication of these results. Therefore, the individual's informed consent was waived by the above ethics committee. We received administrative permission from (Secretary of University/Regional Research Ethics Committee Shahid Sadoughi University of Medical Sciences) to access and use the data. Data used in the study were anonymized. The ethics committee approved this procedure with the above ethical code. The present study was conducted in terms of the principles of the revised Declaration of Helsinki, which waived requirement for informed consent.
Consent for publication Not applicable.
Competing interests All authors declare that they have no conflict of interest regarding this study. • fast, convenient online submission • thorough peer review by experienced researchers in..
References
Alshahrani, Sindi, Alshamsi, Al-Omari, El Tahan et al., Extracorporeal membrane oxygenation for severe Middle East respiratory syndrome coronavirus, Ann Intensive Care,
doi:10.12659/msm.925364
Arabi, Alothman, Balkhy, Al-Dawood, Aljohani et al., Treatment of Middle East respiratory syndrome with a combination of lopinavir-ritonavir and interferon-β1b (MIRACLE trial): study protocol for a randomized controlled trial, Trials,
doi:10.1186/s13063-017-2427-0
Choi, Kim, Ju, -H, Lee et al., The effects of losartan on cytomegalovirus infection in human trabecular meshwork cells, Plos one,
doi:10.1371/journal.pone.0218471
Covid, Team, Covid, Team, Covid et al., Severe outcomes among patients with coronavirus disease 2019 (COVID-19)-United States, Morbidity and mortality weekly report
Flacco, Martellucci, Bravi, Parruti, Cappadona et al., Treatment with ACE inhibitors or ARBs and risk of severe/lethal COVID-19: a meta-analysis, Heart,
doi:10.1136/heartjnl-2020-317336
Guo, Fan, Chen, Wu, Zhang et al., Cardiovascular implications of fatal outcomes of patients with coronavirus disease 2019 (COVID-19), JAMA Cardiol,
doi:10.1001/jamacardio.2020.1017
Horby, Lim, Emberson, Mafham, Bell et al., Dexamethasone in Hospitalized Patients with Covid-19
Ivanov, Mihailović-Stanojević, Milanović, Jovović, Marković-Lipkovski et al., Losartan improved antioxidant defense, renal function and structure of postischemic hypertensive kidney, PloS one,
doi:10.1371/journal.pone.0096353
Kouhpayeh, Shariati, Boshtam, Rahimmanesh, Mirian et al., The molecular story of COVID-19; NAD+ depletion addresses all questions in this infection, Preprints,
doi:10.20944/preprints202003.0346.v1
Liu, Chen, Lin, Han, Clinical features of COVID-19 in elderly patients: a comparison with young and middle-aged patients, J Infection,
doi:10.1016/j.jinf.2020.03.005
Mcintyre, Caffe, Michalak, Reid, Losartan, an orally active angiotensin (AT1) receptor antagonist: a review of its efficacy and safety in essential hypertension, Pharmacol Therap,
doi:10.1016/S0163-7258(97)82002-5
Meng, Xiao, Zhang, He, Ou et al., Renin-angiotensin system inhibitors improve the clinical outcomes of COVID-19 patients with hypertension, Emerg Microb Infect,
doi:10.1080/22221751.2020.1746200
Morse, Lalonde, Xu, Liu, Learning from the past: possible urgent prevention and treatment options for severe acute respiratory infections caused by 2019-nCoV, Chembiochem
Nejat, Sadr, Are losartan and imatinib effective against SARS-CoV2 pathogenesis? A pathophysiologic-based in silico study, silico Pharmacol,
doi:10.1007/s40203-020-00058-7
Nuzzi, Merlo, Specchia, Lombardi, Carubelli et al., The prognostic value of serial troponin measurements in patients admitted for COVID-19, ESC Heart Failure,
doi:10.1002/ehf2.13462
Puskarich, Ingraham, Merck, Driver, Wacker et al., Effect of losartan on hospitalized patients with COVID-19-induced lung injury: A randomized clinical trial, medRxiv,
doi:10.1101/2021.08.25.21262623
Salama, Sadek, Abdelhady, Darweesh, Morsy et al., Losartan may inhibit the progression of liver fibrosis in chronic HCV patients, Hepatob Surg Nutr
Scavone, Brusco, Bertini, Sportiello, Rafaniello et al., Current pharmacological treatments for COVID-19: What's next?, Br J Pharmacol,
doi:10.1111/bph.15072
Sellers, Milad, Chan, Mielnik, Jermilova et al., Inhibition of Marfan Syndrome Aortic Root Dilation by Losartan: Role of Angiotensin II Receptor Type 1-Independent Activation of Endothelial Function, Am J Pathol,
doi:10.1016/j.ajpath.2017.11.006
Shi, Zhang, Jiang, Zhang, Hu et al., Clinical characteristics and risk factors for mortality of COVID-19 patients with diabetes in Wuhan, China: a two-center, retrospective study, Diabetes care,
doi:10.2337/dc20-0598
Tncpere, Vital surveillances: the epidemiological characteristics of an outbreak of 2019 novel coronavirus disease (COVID-19)-China
Wevers, Hoek Lvd, Renin-angiotensin system in human coronavirus pathogenesis, Future Virol,
doi:10.2217/fvl.10.4
Wu, Mcgoogan, Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention, Jama,
doi:10.1001/jama.2020.2648
Zeinalian, Salari-Jazi, Jannesari, Khanahmad, A potential protective role of losartan against coronavirus-induced lung damage, Infection Control Hosp Epidemiol,
doi:10.1017/ice.2020.80
Zhang, Wang, Jia, Li, Hu et al., Risk factors for disease severity, unimprovement, and mortality in COVID-19 patients in Wuhan, China, Clin Microbiol Infect,
doi:10.1016/j.cmi.2020.04.012
Zhou, Yu, Du, Fan, Liu et al., Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study, Lancet,
doi:10.1016/S0140-6736(20)30566-3
{ 'indexed': {'date-parts': [[2023, 9, 1]], 'date-time': '2023-09-01T10:24:29Z', 'timestamp': 1693563869569},
'reference-count': 29,
'publisher': 'Springer Science and Business Media LLC',
'issue': '1',
'license': [ { 'start': { 'date-parts': [[2022, 3, 19]],
'date-time': '2022-03-19T00:00:00Z',
'timestamp': 1647648000000},
'content-version': 'tdm',
'delay-in-days': 0,
'URL': 'https://creativecommons.org/licenses/by/4.0'},
{ 'start': { 'date-parts': [[2022, 3, 19]],
'date-time': '2022-03-19T00:00:00Z',
'timestamp': 1647648000000},
'content-version': 'vor',
'delay-in-days': 0,
'URL': 'https://creativecommons.org/licenses/by/4.0'}],
'funder': [{'name': 'Yazd University of Medical Sciences', 'award': ['7867', '7867', '7867', '7867']}],
'content-domain': {'domain': ['link.springer.com'], 'crossmark-restriction': False},
'published-print': {'date-parts': [[2022, 12]]},
'abstract': '<jats:title>Abstract</jats:title><jats:sec>\n'
' <jats:title>Background</jats:title>\n'
' <jats:p>One of the global problems is to control the coronavirus epidemic, '
'and the role of different medicines is still unknown to policymakers. This study was '
'conducted to evaluate the effects of losartan on the mortality rate of COVID-19 in '
'hypertensive patients.</jats:p>\n'
' </jats:sec><jats:sec>\n'
' <jats:title>Methods</jats:title>\n'
' <jats:p>The research sample of analytical study included 1458 patients '
'presenting to COVID-19 diagnostic centers in Yazd that were examined in the first six months '
'of 2020. Data were analyzed using descriptive statistics as well as chi-square, Fisher’s '
'exact test, <jats:italic>t</jats:italic> test, and logistic regression.</jats:p>\n'
' </jats:sec><jats:sec>\n'
' <jats:title>Results</jats:title>\n'
' <jats:p>Of 1458 subjects that were studied, 280 were hypertensive of whom 179 '
'tested positive for SARS-CoV-2 PCR. The results showed a lower chance of death by more than 5 '
'times in hypertensive patients who used losartan (<jats:italic>P</jats:italic> = 0.003).\xa0'
'Moreover, regarding the effect of losartan on the prevention of COVID-19 in hypertensive '
'patients, it was found that this medicine played a protective role although this relationship '
'was not statistically significant (<jats:italic>P</jats:italic> = 0.86).</jats:p>\n'
' </jats:sec><jats:sec>\n'
' <jats:title>Conclusions</jats:title>\n'
' <jats:p>The results showed that losartan reduced the chance of mortality in '
'hypertensive patients. It is recommended that the effect of losartan and other blood pressure '
'medicines on COVID-19 patients be investigated in larger studies as well as laboratory '
'investigations.</jats:p>\n'
' </jats:sec>',
'DOI': '10.1186/s12872-022-02548-2',
'type': 'journal-article',
'created': {'date-parts': [[2022, 3, 19]], 'date-time': '2022-03-19T12:03:22Z', 'timestamp': 1647691402000},
'update-policy': 'http://dx.doi.org/10.1007/springer_crossmark_policy',
'source': 'Crossref',
'is-referenced-by-count': 3,
'title': 'Does Losartan reduce the severity of COVID-19 in hypertensive patients?',
'prefix': '10.1186',
'volume': '22',
'author': [ {'given': 'Mohammadreza', 'family': 'Mirjalili', 'sequence': 'first', 'affiliation': []},
{'given': 'Moslem Taheri', 'family': 'Soodejani', 'sequence': 'additional', 'affiliation': []},
{'given': 'Mehdi', 'family': 'Raadabadi', 'sequence': 'additional', 'affiliation': []},
{'given': 'Ali', 'family': 'Dehghani', 'sequence': 'additional', 'affiliation': []},
{'given': 'Fateme', 'family': 'Salemi', 'sequence': 'additional', 'affiliation': []}],
'member': '297',
'published-online': {'date-parts': [[2022, 3, 19]]},
'reference': [ { 'issue': '2',
'key': '2548_CR1',
'doi-asserted-by': 'publisher',
'first-page': '135',
'DOI': '10.3390/v12020135',
'volume': '12',
'author': 'LE Gralinski',
'year': '2020',
'unstructured': 'Gralinski LE, Menachery VD. Return of the Coronavirus: 2019-nCoV. '
'Viruses. 2020;12(2):135. https://doi.org/10.3390/v12020135.',
'journal-title': 'Viruses'},
{ 'issue': '1',
'key': '2548_CR2',
'doi-asserted-by': 'publisher',
'first-page': '1',
'DOI': '10.12659/msm.925364',
'volume': '8',
'author': 'MS Alshahrani',
'year': '2018',
'unstructured': 'Alshahrani MS, Sindi A, Alshamsi F, Al-Omari A, El Tahan M, Alahmadi B, '
'et al. Extracorporeal membrane oxygenation for severe Middle East '
'respiratory syndrome coronavirus. Ann Intensive Care. 2018;8(1):1–10. '
'https://doi.org/10.12659/msm.925364.',
'journal-title': 'Ann Intensive Care'},
{ 'issue': '10229',
'key': '2548_CR3',
'doi-asserted-by': 'publisher',
'first-page': '1054',
'DOI': '10.1016/S0140-6736(20)30566-3',
'volume': '395',
'author': 'F Zhou',
'year': '2020',
'unstructured': 'Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk '
'factors for mortality of adult inpatients with COVID-19 in Wuhan, China: '
'a retrospective cohort study. Lancet. 2020;395(10229):1054–62. '
'https://doi.org/10.1016/S0140-6736(20)30566-3.',
'journal-title': 'Lancet'},
{ 'issue': '7',
'key': '2548_CR4',
'doi-asserted-by': 'publisher',
'first-page': '1382',
'DOI': '10.2337/dc20-0598',
'volume': '43',
'author': 'Q Shi',
'year': '2020',
'unstructured': 'Shi Q, Zhang X, Jiang F, Zhang X, Hu N, Bimu C, et al. Clinical '
'characteristics and risk factors for mortality of COVID-19 patients with '
'diabetes in Wuhan, China: a two-center, retrospective study. Diabetes '
'care. 2020;43(7):1382–91. https://doi.org/10.2337/dc20-0598.',
'journal-title': 'Diabetes care'},
{ 'issue': '6',
'key': '2548_CR5',
'doi-asserted-by': 'publisher',
'first-page': 'e14-e8',
'DOI': '10.1016/j.jinf.2020.03.005',
'volume': '80',
'author': 'K Liu',
'year': '2020',
'unstructured': 'Liu K, Chen Y, Lin R, Han K. Clinical features of COVID-19 in elderly '
'patients: a comparison with young and middle-aged patients. J Infection. '
'2020;80(6):e14–8. https://doi.org/10.1016/j.jinf.2020.03.005.',
'journal-title': 'J Infection'},
{ 'issue': '13',
'key': '2548_CR6',
'doi-asserted-by': 'publisher',
'first-page': '1239',
'DOI': '10.1001/jama.2020.2648',
'volume': '323',
'author': 'Z Wu',
'year': '2020',
'unstructured': 'Wu Z, McGoogan JM. Characteristics of and important lessons from the '
'coronavirus disease 2019 (COVID-19) outbreak in China: summary of a '
'report of 72 314 cases from the Chinese Center for Disease Control and '
'Prevention. Jama. 2020;323(13):1239–42. '
'https://doi.org/10.1001/jama.2020.2648.',
'journal-title': 'Jama'},
{ 'key': '2548_CR7',
'doi-asserted-by': 'publisher',
'unstructured': 'Puskarich MA, Ingraham NE, Merck LH, Driver BE, Wacker DA, Black LP, et '
'al. Effect of losartan on hospitalized patients with COVID-19-induced '
'lung injury: A randomized clinical trial. medRxiv. 2021. '
'https://doi.org/10.1101/2021.08.25.21262623.',
'DOI': '10.1101/2021.08.25.21262623'},
{ 'issue': '1',
'key': '2548_CR8',
'doi-asserted-by': 'publisher',
'first-page': '1',
'DOI': '10.1007/s40203-020-00058-7',
'volume': '9',
'author': 'R Nejat',
'year': '2021',
'unstructured': 'Nejat R, Sadr AS. Are losartan and imatinib effective against SARS-CoV2 '
'pathogenesis? A pathophysiologic-based in silico study. In silico '
'Pharmacol. 2021;9(1):1–22. https://doi.org/10.1007/s40203-020-00058-7.',
'journal-title': 'In silico Pharmacol'},
{ 'key': '2548_CR9',
'doi-asserted-by': 'publisher',
'first-page': '1',
'DOI': '10.1186/s13063-017-2427-0',
'volume': '19',
'author': 'YM Arabi',
'year': '2018',
'unstructured': 'Arabi YM, Alothman A, Balkhy HH, Al-Dawood A, AlJohani S, Al Harbi S, et '
'al. Treatment of Middle East respiratory syndrome with a combination of '
'lopinavir-ritonavir and interferon-β1b (MIRACLE trial): study protocol '
'for a randomized controlled trial. Trials. 2018;19:1–13. '
'https://doi.org/10.1186/s13063-017-2427-0.',
'journal-title': 'Trials.'},
{ 'key': '2548_CR10',
'doi-asserted-by': 'crossref',
'unstructured': 'Horby P, Lim WS, Emberson JR, Mafham M, Bell JL, Linsell L. '
'Dexamethasone in Hospitalized Patients with Covid-19. '
'2021;384(8):693–704. https://dx.doi.org/10.1056%2FNEJMoa2021436.',
'DOI': '10.1056/NEJMoa2021436'},
{ 'issue': '21',
'key': '2548_CR11',
'doi-asserted-by': 'publisher',
'first-page': '4813',
'DOI': '10.1111/bph.15072',
'volume': '177',
'author': 'C Scavone',
'year': '2020',
'unstructured': 'Scavone C, Brusco S, Bertini M, Sportiello L, Rafaniello C, Zoccoli A, '
'et al. Current pharmacological treatments for COVID-19: What’s next? Br '
'J Pharmacol. 2020;177(21):4813–24. https://doi.org/10.1111/bph.15072.',
'journal-title': 'Br J Pharmacol'},
{ 'key': '2548_CR12',
'doi-asserted-by': 'publisher',
'DOI': '10.20944/preprints202003.0457.v1',
'author': 'AS Jazzi',
'year': '2020',
'unstructured': 'Jazzi AS, Mahnam K, Hejazi SH, Damavandi MS, Sadeghi P, Zeinalian M, et '
'al. Inhibition of viral macrodomain of covid-19 and human trpm2 by '
'losartan. Preprint. 2020. '
'https://doi.org/10.20944/preprints202003.0457.v1.',
'journal-title': 'Preprint'},
{ 'issue': '6',
'key': '2548_CR13',
'doi-asserted-by': 'publisher',
'first-page': '752',
'DOI': '10.1017/ice.2020.80',
'volume': '41',
'author': 'M Zeinalian',
'year': '2020',
'unstructured': 'Zeinalian M, Salari-Jazi A, Jannesari A, Khanahmad H. A potential '
'protective role of losartan against coronavirus-induced lung damage. '
'Infection Control Hosp Epidemiol. 2020;41(6):752–3. '
'https://doi.org/10.1017/ice.2020.80.',
'journal-title': 'Infection Control Hosp Epidemiol'},
{ 'issue': '19',
'key': '2548_CR14',
'doi-asserted-by': 'publisher',
'first-page': '1519',
'DOI': '10.1136/heartjnl-2020-317336',
'volume': '106',
'author': 'ME Flacco',
'year': '2020',
'unstructured': 'Flacco ME, Martellucci CA, Bravi F, Parruti G, Cappadona R, Mascitelli '
'A, et al. Treatment with ACE inhibitors or ARBs and risk of '
'severe/lethal COVID-19: a meta-analysis. Heart. 2020;106(19):1519–24. '
'https://doi.org/10.1136/heartjnl-2020-317336.',
'journal-title': 'Heart'},
{ 'issue': '2',
'key': '2548_CR15',
'doi-asserted-by': 'publisher',
'first-page': '145',
'DOI': '10.2217/fvl.10.4',
'volume': '5',
'author': 'BA Wevers',
'year': '2010',
'unstructured': 'Wevers BA. Hoek Lvd. Renin–angiotensin system in human coronavirus '
'pathogenesis. Future Virol. 2010;5(2):145–61. '
'https://doi.org/10.2217/fvl.10.4.',
'journal-title': 'Future Virol'},
{ 'key': '2548_CR16',
'doi-asserted-by': 'publisher',
'unstructured': 'Clarke NE, Turner AJ. Angiotensin-converting enzyme 2: the first decade. '
'Int J Hypertens. 2012;2012. https://doi.org/10.1155/2012/307315.',
'DOI': '10.1155/2012/307315'},
{ 'issue': '2',
'key': '2548_CR17',
'doi-asserted-by': 'publisher',
'first-page': '181',
'DOI': '10.1016/S0163-7258(97)82002-5',
'volume': '74',
'author': 'M McIntyre',
'year': '1997',
'unstructured': 'McIntyre M, Caffe S, Michalak R, Reid J. Losartan, an orally active '
'angiotensin (AT1) receptor antagonist: a review of its efficacy and '
'safety in essential hypertension. Pharmacol Therap. 1997;74(2):181–94. '
'https://doi.org/10.1016/S0163-7258(97)82002-5.',
'journal-title': 'Pharmacol Therap'},
{ 'issue': '3',
'key': '2548_CR18',
'doi-asserted-by': 'publisher',
'first-page': '249',
'DOI': '10.21037/hbsn.2016.02.06',
'volume': '5',
'author': 'ZA Salama',
'year': '2016',
'unstructured': 'Salama ZA, Sadek A, Abdelhady AM, Darweesh SK, Morsy SA, Esmat G. '
'Losartan may inhibit the progression of liver fibrosis in chronic HCV '
'patients. Hepatob Surg Nutr. 2016;5(3):249.',
'journal-title': 'Hepatob Surg Nutr'},
{ 'issue': '3',
'key': '2548_CR19',
'doi-asserted-by': 'publisher',
'first-page': '574',
'DOI': '10.1016/j.ajpath.2017.11.006',
'volume': '188',
'author': 'SL Sellers',
'year': '2018',
'unstructured': 'Sellers SL, Milad N, Chan R, Mielnik M, Jermilova U, Huang PL, et al. '
'Inhibition of Marfan Syndrome Aortic Root Dilation by Losartan: Role of '
'Angiotensin II Receptor Type 1–Independent Activation of Endothelial '
'Function. Am J Pathol. 2018;188(3):574–85. '
'https://doi.org/10.1016/j.ajpath.2017.11.006.',
'journal-title': 'Am J Pathol'},
{ 'issue': '6',
'key': '2548_CR20',
'doi-asserted-by': 'publisher',
'first-page': 'e0218471',
'DOI': '10.1371/journal.pone.0218471',
'volume': '14',
'author': 'JA Choi',
'year': '2019',
'unstructured': 'Choi JA, Kim J-E, Ju H-h, Lee J, Jee D, Park CK, et al. The effects of '
'losartan on cytomegalovirus infection in human trabecular meshwork '
'cells. Plos one. 2019;14(6):e0218471. '
'https://doi.org/10.1371/journal.pone.0218471.',
'journal-title': 'Plos one'},
{ 'issue': '5',
'key': '2548_CR21',
'doi-asserted-by': 'publisher',
'first-page': '730',
'DOI': '10.1002/cbic.202000047',
'volume': '21',
'author': 'JS Morse',
'year': '2020',
'unstructured': 'Morse JS, Lalonde T, Xu S, Liu WR. Learning from the past: possible '
'urgent prevention and treatment options for severe acute respiratory '
'infections caused by 2019-nCoV. Chembiochem. 2020;21(5):730. '
'https://dx.doi.org/10.1002%2Fcbic.202000047.',
'journal-title': 'Chembiochem'},
{ 'issue': '5',
'key': '2548_CR22',
'doi-asserted-by': 'publisher',
'first-page': 'e96353',
'DOI': '10.1371/journal.pone.0096353',
'volume': '9',
'author': 'M Ivanov',
'year': '2014',
'unstructured': 'Ivanov M, Mihailović-Stanojević N, Grujić Milanović J, Jovović Đ, '
'Marković-Lipkovski J, Ćirović S, et al. Losartan improved antioxidant '
'defense, renal function and structure of postischemic hypertensive '
'kidney. PloS one. 2014;9(5):e96353. '
'https://doi.org/10.1371/journal.pone.0096353.',
'journal-title': 'PloS one'},
{ 'key': '2548_CR23',
'doi-asserted-by': 'publisher',
'unstructured': 'Kouhpayeh S, Shariati L, Boshtam M, Rahimmanesh I, Mirian M, Zeinalian '
'M, et al. The molecular story of COVID-19; NAD+ depletion addresses all '
'questions in this infection. 2020. Kouhpayeh, S.; Shariati, L.; Boshtam, '
'M.; Rahimmanesh, I.; Mirian, M.; Zeinalian, M.; Salari-jazi, A.; '
'Khanahmad, N.; Damavandi, M.S.; Sadeghi, P.; Khanahmad, H. The Molecular '
'Story of COVID-19; NAD+ Depletion Addresses All Questions in this '
'Infection. Preprints 2020, 2020030346 '
'https://doi.org/10.20944/preprints202003.0346.v1.',
'DOI': '10.20944/preprints202003.0346.v1'},
{ 'key': '2548_CR24',
'doi-asserted-by': 'crossref',
'unstructured': 'Covid C, Team R, COVID C, Team R, COVID C, Team R, et al. Severe '
'outcomes among patients with coronavirus disease 2019 (COVID-19)—United '
'States, February 12–March 16, 2020. Morbidity and mortality weekly '
'report. 2020;69(12):343. https://dx.doi.org/10.15585%2Fmmwr.mm6912e2.',
'DOI': '10.15585/mmwr.mm6912e2'},
{ 'key': '2548_CR25',
'unstructured': 'TNCPERE T. Vital surveillances: the epidemiological characteristics of '
'an outbreak of 2019 novel coronavirus disease (COVID-19)-China, 2020. '
'2020.'},
{ 'issue': '6',
'key': '2548_CR26',
'doi-asserted-by': 'publisher',
'first-page': '767',
'DOI': '10.1016/j.cmi.2020.04.012',
'volume': '26',
'author': 'J Zhang',
'year': '2020',
'unstructured': 'Zhang J, Wang X, Jia X, Li J, Hu K, Chen G, et al. Risk factors for '
'disease severity, unimprovement, and mortality in COVID-19 patients in '
'Wuhan, China. Clin Microbiol Infect. 2020;26(6):767–72. '
'https://doi.org/10.1016/j.cmi.2020.04.012.',
'journal-title': 'Clin Microbiol Infect'},
{ 'issue': '7',
'key': '2548_CR27',
'doi-asserted-by': 'publisher',
'first-page': '811',
'DOI': '10.1001/jamacardio.2020.1017',
'volume': '5',
'author': 'T Guo',
'year': '2020',
'unstructured': 'Guo T, Fan Y, Chen M, Wu X, Zhang L, He T, et al. Cardiovascular '
'implications of fatal outcomes of patients with coronavirus disease 2019 '
'(COVID-19). JAMA Cardiol. 2020;5(7):811–8. '
'https://doi.org/10.1001/jamacardio.2020.1017.',
'journal-title': 'JAMA Cardiol'},
{ 'issue': '5',
'key': '2548_CR28',
'doi-asserted-by': 'publisher',
'first-page': '3504',
'DOI': '10.1002/ehf2.13462',
'volume': '8',
'author': 'V Nuzzi',
'year': '2021',
'unstructured': 'Nuzzi V, Merlo M, Specchia C, Lombardi CM, Carubelli V, Iorio A, et al. '
'The prognostic value of serial troponin measurements in patients '
'admitted for COVID-19. ESC Heart Failure. 2021;8(5):3504–11. '
'https://doi.org/10.1002/ehf2.13462.',
'journal-title': 'ESC Heart Failure'},
{ 'issue': '1',
'key': '2548_CR29',
'doi-asserted-by': 'publisher',
'first-page': '757',
'DOI': '10.1080/22221751.2020.1746200',
'volume': '9',
'author': 'J Meng',
'year': '2020',
'unstructured': 'Meng J, Xiao G, Zhang J, He X, Ou M, Bi J, et al. Renin-angiotensin '
'system inhibitors improve the clinical outcomes of COVID-19 patients '
'with hypertension. Emerg Microb Infect. 2020;9(1):757–60. '
'https://doi.org/10.1080/22221751.2020.1746200.',
'journal-title': 'Emerg Microb Infect'}],
'container-title': 'BMC Cardiovascular Disorders',
'original-title': [],
'language': 'en',
'link': [ { 'URL': 'https://link.springer.com/content/pdf/10.1186/s12872-022-02548-2.pdf',
'content-type': 'application/pdf',
'content-version': 'vor',
'intended-application': 'text-mining'},
{ 'URL': 'https://link.springer.com/article/10.1186/s12872-022-02548-2/fulltext.html',
'content-type': 'text/html',
'content-version': 'vor',
'intended-application': 'text-mining'},
{ 'URL': 'https://link.springer.com/content/pdf/10.1186/s12872-022-02548-2.pdf',
'content-type': 'application/pdf',
'content-version': 'vor',
'intended-application': 'similarity-checking'}],
'deposited': { 'date-parts': [[2022, 3, 19]],
'date-time': '2022-03-19T12:09:27Z',
'timestamp': 1647691767000},
'score': 1,
'resource': { 'primary': { 'URL': 'https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-022-02548-2'}},
'subtitle': [],
'short-title': [],
'issued': {'date-parts': [[2022, 3, 19]]},
'references-count': 29,
'journal-issue': {'issue': '1', 'published-print': {'date-parts': [[2022, 12]]}},
'alternative-id': ['2548'],
'URL': 'http://dx.doi.org/10.1186/s12872-022-02548-2',
'relation': {},
'ISSN': ['1471-2261'],
'subject': [],
'container-title-short': 'BMC Cardiovasc Disord',
'published': {'date-parts': [[2022, 3, 19]]},
'assertion': [ { 'value': '22 August 2021',
'order': 1,
'name': 'received',
'label': 'Received',
'group': {'name': 'ArticleHistory', 'label': 'Article History'}},
{ 'value': '8 March 2022',
'order': 2,
'name': 'accepted',
'label': 'Accepted',
'group': {'name': 'ArticleHistory', 'label': 'Article History'}},
{ 'value': '19 March 2022',
'order': 3,
'name': 'first_online',
'label': 'First Online',
'group': {'name': 'ArticleHistory', 'label': 'Article History'}},
{'order': 1, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Declarations'}},
{ 'value': 'The article’s proposal was approved by the ethics committee of Shahid Sadoughi '
'University of Medical Sciences with the ID of IR.SSU.REC.1399.101. Due to the '
'retrospective nature of the study, no study specific consent form was used. '
'However, patients admitted to our hospital are asked to sign a general consent '
'upon admission, which covers the collection of patient data and publication of '
'these results. Therefore, the individual’s informed consent was waived by the '
'above ethics committee. We received administrative permission from (Secretary '
'of University/Regional Research Ethics Committee Shahid Sadoughi University of '
'Medical Sciences) to access and use the data. Data used in the study were '
'anonymized. The ethics committee approved this procedure with the above '
'ethical code. The present study was conducted in terms of the principles of '
'the revised Declaration of Helsinki, which waived requirement for informed '
'consent.',
'order': 2,
'name': 'Ethics',
'group': { 'name': 'EthicsHeading',
'label': "<!--Emphasis Type='Bold' removed-->Ethics approval and consent to "
'participate'}},
{ 'value': 'Not applicable.',
'order': 3,
'name': 'Ethics',
'group': { 'name': 'EthicsHeading',
'label': "<!--Emphasis Type='Bold' removed-->Consent for publication"}},
{ 'value': 'All authors declare that they have no conflict of interest regarding this '
'study.',
'order': 4,
'name': 'Ethics',
'group': { 'name': 'EthicsHeading',
'label': "<!--Emphasis Type='Bold' removed-->Competing interests"}}],
'article-number': '116'}