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Protecting older patients with cardiovascular diseases from COVID-19 complications using current medications

Mariana Alves1, Marília Andreia Fernandes2, Gülistan Bahat3

  • 1Faculty of Medicine, Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Serviço de Medicina III, Hospital Pulido Valente, CHULNUniversity of LisbonUniversidade de Lisboa, Lisbon, Portugal.

European Geriatric Medicine
|May 25, 2021
PubMed

Insights

Cardiovascular drugs may protect patients with COVID-19, but evidence is limited. Continue most medications safely, considering individual patient factors and ongoing clinical trials for definitive answers.

Area of Science:

  • Cardiovascular Medicine
  • Infectious Diseases
  • Pharmacology

Background:

  • Severe COVID-19 involves renin-angiotensin-aldosterone system (RAAS) derangements, vascular dysfunction, inflammation, coagulopathy, and arrhythmias.
  • Cardiovascular diseases are common comorbidities in patients with severe COVID-19.
  • Existing cardiovascular medications may offer protective benefits.

Purpose of the Study:

  • To review the current use and potential benefits of conventional cardiovascular drugs and other commonly used medications in COVID-19 patients with cardiovascular diseases.
  • To assess the safety and efficacy of continuing existing drug regimens during COVID-19 infection.

Main Methods:

  • A literature review of clinical databases focusing on COVID-19 and cardiovascular drug keywords.
  • Analysis of retrospective and observational studies on drug use in COVID-19 patients.
  • Consensus-based recommendations from all authors.

Main Results:

  • Several cardiovascular drug classes show potential protective effects in COVID-19, though evidence primarily comes from observational studies.
  • Ongoing randomized controlled trials (RCTs) are investigating antithrombotics, pulmonary vasodilators, RAAS-related drugs, and colchicine.
  • Long-term benefits of therapies like statins may not be fully captured in acute-phase COVID-19 studies.

Conclusions:

  • Most cardiovascular medications can be safely continued in COVID-19 patients.
  • Certain drug classes may offer protective effects against severe COVID-19 complications.
  • Individualized consideration is crucial for older patients due to frailty, comorbidities, and polypharmacy, as age-specific data are limited.
Abstract

Keywords:
AntiarrhytmicAnticoaculantAspirinCOVID-19ColchicineDiabetesNSAIDRAASStatinVitamin D

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