Background: Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin-II receptor blockers (ARBs) have been an arguable risk factor for COVID-19 diseases because they could upregulate Angiotensin Converting Enz...Background: Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin-II receptor blockers (ARBs) have been an arguable risk factor for COVID-19 diseases because they could upregulate Angiotensin Converting Enzyme-2 (ACE2) expression, facilitating SARS-CoV2 entry to the lungs. Several retrospective clinical studies, however, found no such effect. Here, we explore how the use of ACEIs and ARBs links to COVID-19 across all countries of the world. Methods: Data on the availability of ACEIs and ARBs for 200 countries and on the number of cases and number of deaths per country by 28 December 2020 were extracted from WHO and Worldometer website, respectively. Data on life expectancy at age 65 years as a measure of ageing were from WHO and on Gross Domestic Product Per Capita (GDP PPP) and the percentage of urbanization were from the World Bank. Excel and SPSS v 26 software were used for statistical analyses. Results: In linear regression and logistic conditional regression analysis, GDP correlates with COVID-19 prevalence (rho = 0.66, p > 0.001) and deaths from COVID-19 (rho = 0.55, p < 0.001) while urbanization and life expectancy do not when GDP influence is controlled for. After statistically removing the effects of GDP on the prevalence and mortality from COVID-19, we found that countries without ACEI and ARB availability had lower COVID-19 cases and deaths (p < 0.02). Conclusions: Our study based on the global data contradicts findings of most published clinical studies at regional levels. We found that GDP positively correlates with prevalence of and mortality related to COVID-19. ACEI and ARB use increases COVID-19 infectivity and mortality.展开更多
Background:immune checkpoint inhibitors(ICIs)have revolutionized the treatment of metastatic urothelial carcinoma(mUC),significantly improving survival outcomes.However,a subset of patients do not respond to ICIs,prom...Background:immune checkpoint inhibitors(ICIs)have revolutionized the treatment of metastatic urothelial carcinoma(mUC),significantly improving survival outcomes.However,a subset of patients do not respond to ICIs,prompting research into potential predictive factors.Commonly prescribed medications such as corticosteroids,proton-pump inhibitors(PPIs),antibiotics(Abs),antihypertensives,and analgesics may influence ICI effectiveness.Methods:we conducted a literature search on PubMed to investigate the impact of concomitant medications on the outcomes of patients with mUC,treated with ICIs.We selected the most relevant studies and performed a narrative review.Results:corticosteroids,PPIs and Abs have been associated with reduced survival in ICI-treated patients,including those with mUC.In contrast,antihypertensive agents like renin-angiotensin system inhibitors and betablockers may enhance ICI efficacy,though evidence remains inconclusive.The impact of other medications,such as statins,metformin,and analgesics,on ICI outcomes is less clear,with some data suggesting a detrimental impact on immune response.Conclusions:this narrative review synthesizes current evidence on how concomitant medications affect outcomes in mUC patients treated with ICIs.展开更多
文摘Background: Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin-II receptor blockers (ARBs) have been an arguable risk factor for COVID-19 diseases because they could upregulate Angiotensin Converting Enzyme-2 (ACE2) expression, facilitating SARS-CoV2 entry to the lungs. Several retrospective clinical studies, however, found no such effect. Here, we explore how the use of ACEIs and ARBs links to COVID-19 across all countries of the world. Methods: Data on the availability of ACEIs and ARBs for 200 countries and on the number of cases and number of deaths per country by 28 December 2020 were extracted from WHO and Worldometer website, respectively. Data on life expectancy at age 65 years as a measure of ageing were from WHO and on Gross Domestic Product Per Capita (GDP PPP) and the percentage of urbanization were from the World Bank. Excel and SPSS v 26 software were used for statistical analyses. Results: In linear regression and logistic conditional regression analysis, GDP correlates with COVID-19 prevalence (rho = 0.66, p > 0.001) and deaths from COVID-19 (rho = 0.55, p < 0.001) while urbanization and life expectancy do not when GDP influence is controlled for. After statistically removing the effects of GDP on the prevalence and mortality from COVID-19, we found that countries without ACEI and ARB availability had lower COVID-19 cases and deaths (p < 0.02). Conclusions: Our study based on the global data contradicts findings of most published clinical studies at regional levels. We found that GDP positively correlates with prevalence of and mortality related to COVID-19. ACEI and ARB use increases COVID-19 infectivity and mortality.
文摘Background:immune checkpoint inhibitors(ICIs)have revolutionized the treatment of metastatic urothelial carcinoma(mUC),significantly improving survival outcomes.However,a subset of patients do not respond to ICIs,prompting research into potential predictive factors.Commonly prescribed medications such as corticosteroids,proton-pump inhibitors(PPIs),antibiotics(Abs),antihypertensives,and analgesics may influence ICI effectiveness.Methods:we conducted a literature search on PubMed to investigate the impact of concomitant medications on the outcomes of patients with mUC,treated with ICIs.We selected the most relevant studies and performed a narrative review.Results:corticosteroids,PPIs and Abs have been associated with reduced survival in ICI-treated patients,including those with mUC.In contrast,antihypertensive agents like renin-angiotensin system inhibitors and betablockers may enhance ICI efficacy,though evidence remains inconclusive.The impact of other medications,such as statins,metformin,and analgesics,on ICI outcomes is less clear,with some data suggesting a detrimental impact on immune response.Conclusions:this narrative review synthesizes current evidence on how concomitant medications affect outcomes in mUC patients treated with ICIs.
