Does your high blood pressure and diabetes mellitus increase your risk to get severe corona virus infection?

Does your high blood pressure and diabetes mellitus increase your risk to get severe corona virus infection?

Studies coming from China and other countries have shown clearly that at least a quarter of patients with very severe corona virus infections are associated with a high blood pressure. Other diseases such as diabetes, coronary artery or cerebrovascular diseases are also common in those patients needing admission to hospital and to ITU. The Lancet (Link) has therefore raised a very serious question, then proposed a hypothesis, that patients with high blood pressure and diabetes are at particularly increased risk! Is there a molecular basis for this? Yes there seem to be a strong one.

Corona virus (also known as SARS-CoV-2) is able to bind to human cells using small receptors called ACE2 (Angiotensin-converting enzyme 2). These receptors are mainly found in the tissues of the lung, bowel, kidney and blood vessels.

Now here is the point: Patients with diabetes or with hypertension (who are treated with a medication called ACE inhibitors) are well known to have excessive number of ACE2 receptors. The same receptors increase also when the patient takes Ibuprofen as well (remember what the French health authorities noticed once!).

ACE2 are also known to be higher in certain individuals due to genetic difference (ACE2 polymorphism). This also can explain why SARS-CoV-2 does hit certain people harder than others.

It is therefore the recommendation from the Lancet that if you are treated for a high blood pressure or diabetes, and you are using any of the above medications (that increase the expression of ACE2 in your body), then you better discuss with your doctor ASAP as you are probably (according to this hypothesis) at higher risk to develop severe corona virus infection if you get infected.

Interesting enough, there is no report in the literature to suggest that the other medication to treat high blood pressure, namely the calcium channel inhibitors, do increase the ACE2 receptors. This is probably more suitable alternative to ACE inhibitors during this period.

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Some updates from the British Medical Journal:

Use of ACE inhibitors and angiotensin-II receptor antagonists link

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