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| Blood Pressure Drugs Don’t Increase Coronavirus Risk, Studies Find | Blood Pressure Drugs Don’t Increase Coronavirus Risk, Studies Find |
| (14 days later) | |
| Drugs that are widely prescribed to treat high blood pressure do not make patients more susceptible to coronavirus infection, or to severe illness if they do become infected, researchers reported on Friday. | Drugs that are widely prescribed to treat high blood pressure do not make patients more susceptible to coronavirus infection, or to severe illness if they do become infected, researchers reported on Friday. |
| Their findings are good news for millions of people who take blood pressure drugs that belong to two classes: ACE inhibitors, which include lisinopril, captopril and other drugs with generic names ending in –pril; and ARBs, which include losartan, valsartan and other generic drugs ending in –sartan. Brand names for ACE inhibitors include Zestril and Prinivil; for ARBs, Cozaar and Atacand. | Their findings are good news for millions of people who take blood pressure drugs that belong to two classes: ACE inhibitors, which include lisinopril, captopril and other drugs with generic names ending in –pril; and ARBs, which include losartan, valsartan and other generic drugs ending in –sartan. Brand names for ACE inhibitors include Zestril and Prinivil; for ARBs, Cozaar and Atacand. |
| Since the epidemic began, conflicting theories have circulated about whether those drugs could make the disease better or worse, or have any effect at all. | Since the epidemic began, conflicting theories have circulated about whether those drugs could make the disease better or worse, or have any effect at all. |
| The new research was published Friday by The New England Journal of Medicine, and similar findings from China were published last week in JAMA Cardiology. | The new research was published Friday by The New England Journal of Medicine, and similar findings from China were published last week in JAMA Cardiology. |
| The U.S. study also found no risk linked to three other classes of commonly used blood pressure drugs — beta blockers, calcium-channel blockers and thiazide diuretics. | The U.S. study also found no risk linked to three other classes of commonly used blood pressure drugs — beta blockers, calcium-channel blockers and thiazide diuretics. |
| Both studies were based on reviewing patients’ records, which does not provide evidence as strong as the results of controlled clinical trials, where patients are picked at random to take one treatment or another. | Both studies were based on reviewing patients’ records, which does not provide evidence as strong as the results of controlled clinical trials, where patients are picked at random to take one treatment or another. |
| Concerns arose about the drugs early in the epidemic when reports from China indicated that people with hypertension seemed to fare poorly, and it seemed logical to investigate if the cause was the condition itself or if blood pressure drugs were somehow making patients more vulnerable. | Concerns arose about the drugs early in the epidemic when reports from China indicated that people with hypertension seemed to fare poorly, and it seemed logical to investigate if the cause was the condition itself or if blood pressure drugs were somehow making patients more vulnerable. |
| In addition, studies in animals had shown that ARBSs and ACE inhibitors could increase the levels in some tissue of a protein called ACE2, which happens to be the substance that the virus grabs onto as it invades cells. In theory, higher levels of that protein in the lungs might help the virus attack by acting as extra handholds, some scientists have warned. But it is not known whether the drugs actually raise ACE2 in human lungs. | In addition, studies in animals had shown that ARBSs and ACE inhibitors could increase the levels in some tissue of a protein called ACE2, which happens to be the substance that the virus grabs onto as it invades cells. In theory, higher levels of that protein in the lungs might help the virus attack by acting as extra handholds, some scientists have warned. But it is not known whether the drugs actually raise ACE2 in human lungs. |
| Confounding the matter was evidence from animal studies that suggested the opposite effect: The drugs might quell inflammation in the lungs and lower the risk of severe disease in coronavirus patients. A controlled trial is about to begin to find out if ACE inhibitors can help Covid-19 patients, the University of California San Diego School of Medicine announced on Thursday. | Confounding the matter was evidence from animal studies that suggested the opposite effect: The drugs might quell inflammation in the lungs and lower the risk of severe disease in coronavirus patients. A controlled trial is about to begin to find out if ACE inhibitors can help Covid-19 patients, the University of California San Diego School of Medicine announced on Thursday. |
| Not surprisingly, patients have been confused and unsettled. Medical societies have urged calm, saying that people should stick with their medications because high blood pressure increases the risks of heart disease, strokes and kidney damage. But the societies also called for research into the issue, and the fears have lingered. | Not surprisingly, patients have been confused and unsettled. Medical societies have urged calm, saying that people should stick with their medications because high blood pressure increases the risks of heart disease, strokes and kidney damage. But the societies also called for research into the issue, and the fears have lingered. |
| Updated July 7, 2020 | |
| The coronavirus can stay aloft for hours in tiny droplets in stagnant air, infecting people as they inhale, mounting scientific evidence suggests. This risk is highest in crowded indoor spaces with poor ventilation, and may help explain super-spreading events reported in meatpacking plants, churches and restaurants. It’s unclear how often the virus is spread via these tiny droplets, or aerosols, compared with larger droplets that are expelled when a sick person coughs or sneezes, or transmitted through contact with contaminated surfaces, said Linsey Marr, an aerosol expert at Virginia Tech. Aerosols are released even when a person without symptoms exhales, talks or sings, according to Dr. Marr and more than 200 other experts, who have outlined the evidence in an open letter to the World Health Organization. | |
| Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. | |
| Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles. | |
| A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico. | |
| The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth. | |
| The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave. | |
| So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. | |
| Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. | |
| A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. | |
| If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) | |
| If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. | |
| “I worry because I’ve received calls from many patients asking if they should stop their medicine or switch to something else, and some even stopped their medications without asking me,” Dr. Harmony Reynolds, the associate director of the cardiovascular research center at the New York University Grossman School of Medicine, said in an interview. | “I worry because I’ve received calls from many patients asking if they should stop their medicine or switch to something else, and some even stopped their medications without asking me,” Dr. Harmony Reynolds, the associate director of the cardiovascular research center at the New York University Grossman School of Medicine, said in an interview. |
| Some who check their blood pressure at home tell her it is going up, and she is not sure whether the cause is stress from the pandemic, lack of exercise, changes in their eating habits or avoidance of the drugs. | Some who check their blood pressure at home tell her it is going up, and she is not sure whether the cause is stress from the pandemic, lack of exercise, changes in their eating habits or avoidance of the drugs. |
| To address the problem, Dr. Reynolds led a team that analyzed the records of 12,594 people who were tested for the coronavirus, including 5,894 who were infected. Some also had high blood pressure. The goal was to determine whether coronavirus infection or severe illness were more common in people taking the blood pressure drugs. | To address the problem, Dr. Reynolds led a team that analyzed the records of 12,594 people who were tested for the coronavirus, including 5,894 who were infected. Some also had high blood pressure. The goal was to determine whether coronavirus infection or severe illness were more common in people taking the blood pressure drugs. |
| The researchers looked at the patients’ likelihood of being infected, the severity of the illness and the drugs that they were taking before being tested for the virus. They used statistical methods to rule out differences that might be due to age, sex, race, ethnicity, smoking history and other factors. If a blood pressure drug was associated with a difference of more than 10 percent in the risk of being infected or becoming severely ill, they considered that difference “clinically meaningful.” | The researchers looked at the patients’ likelihood of being infected, the severity of the illness and the drugs that they were taking before being tested for the virus. They used statistical methods to rule out differences that might be due to age, sex, race, ethnicity, smoking history and other factors. If a blood pressure drug was associated with a difference of more than 10 percent in the risk of being infected or becoming severely ill, they considered that difference “clinically meaningful.” |
| No meaningful differences emerged. | No meaningful differences emerged. |
| “The main message here is that there is no signal of increased risk, and that should be very reassuring,” Dr. Reynolds said. | “The main message here is that there is no signal of increased risk, and that should be very reassuring,” Dr. Reynolds said. |