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Certain medications may put people at higher risk of a severe COVID-19 infection

Researchers still generally recommend continued use of the drugs, but in consultation with doctors
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Researchers at the University of Waterloo are finding evidence that suggests people with hypertension, diabetes, kidney and heart disease are at a higher risk of severe COVID-19 infection due to their medication.

However, they still recommend people continue their medication, but in consultation with their doctor.

Anita Layton is a professor of Applied Mathematics, Computer Science, Pharmacy and Biology at UW, as well as a Canada 150 Research Chair. She is the co-author on the paper, alongside her student, Mehrshad Sadria.

Their research used a unique mathematical model to predict the severity of COVID-19 in patients who have taken one of two drug classes: angiotensin-converting enzyme inhibitors (ACEi) and angeiotensin II receptor blockers (ARB).

Both act as an anti-inflammatory, which is good for treating severe hypertension, but they also increase the amount of ACE2, a receptor that the SARS-CoV-2 virus uses to enter cells.

"Hypertension is a very complex disease. It can be very serious and can be, you know, just kind of high, right? So depending on how bad you have it with your high-blood pressure, you're reaction to the drug and your reaction to COVID infection can be quite different, so we simulate people with different level of infection; different level of high-blood pressure and we simulate people who get a lot of the virus into the body."

The research suggests that the drug may exacerbate tissue damage for those with only mild chronic inflammation or none at all.

"So the question is, should grandpa keep taking the medication which is good for his blood pressure, but then increase his chance of getting very serious complications from COVID, or should he stop it?" she said.

Layton says it depends on the person and their situation. A discussion that should be held between the patient and their doctor. She says even her modeling is limited to what we know about how the virus or the drugs affect the body under different circumstances.

"You and I will be different because we probably have different race, sex is different, and the age would be different too," she said. Layton notes, for example, that high-blood pressure is sex-specific, with women at a much lower chance of developing the condition, but their response to the drug may also be different as well.

Her current modeling is a generic simulation that doesn't take all those additional factors into consideration and would need further research and iteration. But the current modeling would generally apply for middle-aged white men.

The study was published in the journal PLOS Computational Biology in October.




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