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Angiotensin II Administration in Patients With COVID-19 Shock

Kwadwo Ofosu-Barko1, Yi Liu1, Faisal Alkhatib Tamimi1

  • 1From the Department of Medicine, Lahey Hospital and Medical Center, Burlington, MA.

Critical Pathways in Cardiology
|October 8, 2020
PubMed

Insights

Angiotensin II showed a favorable hemodynamic effect in patients with COVID-19 related shock, reducing the need for norepinephrine equivalent dose. Further research is warranted to evaluate its efficacy in treating this critical condition.

Area of Science:

  • Critical Care Medicine
  • Pharmacology
  • Infectious Diseases

Background:

  • COVID-19 infection can lead to shock, a life-threatening condition.
  • The renin-angiotensin-aldosterone system is implicated in SARS-CoV-2 pathogenesis.
  • Vasopressors are crucial for managing shock, but their optimal use in COVID-19 is under investigation.

Purpose of the Study:

  • To assess the hemodynamic impact of angiotensin II in patients experiencing shock due to COVID-19.
  • To determine if angiotensin II can effectively reduce vasopressor requirements in this patient population.

Main Methods:

  • Retrospective analysis of patients with COVID-19 and shock treated with angiotensin II.
  • Hemodynamic parameters including mean arterial pressure, norepinephrine equivalent dose (NED), and urine output were monitored.
  • Data collected over the initial 6 hours of angiotensin II treatment.

Main Results:

  • Ten patients with COVID-19 related shock received angiotensin II.
  • The average norepinephrine equivalent dose (NED) decreased by 30.4% within 6 hours.
  • Six patients achieved at least a 25% reduction in NED, with two experiencing a >50% reduction; mean arterial pressure remained stable.

Conclusions:

  • Angiotensin II demonstrated a beneficial hemodynamic response in COVID-19 related shock.
  • Two patients exhibited significant and rapid improvement.
  • Further investigation into angiotensin II for COVID-19 shock is recommended due to the virus's interaction with the renin-angiotensin-aldosterone system.
Abstract

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