Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Anciano , Cardiomiopatía Hipertrófica/diagnóstico por imagen , Accidente Cerebrovascular/tratamiento farmacológico , Embolia Intracraneal/etiología , Enfermedad de Moyamoya/terapia , Enfermedad de Moyamoya/diagnóstico por imagen , Fibrilación Atrial/complicaciones , Tomografía Computarizada por Rayos X/métodos , Ecocardiografía Doppler en Color , Inhibidores de Hidroximetilglutaril-CoA Reductasas/farmacología , Accidente Cerebrovascular/complicaciones , Electrocardiografía , Valsartán/farmacología , Terapia Antiplaquetaria Doble/métodos , Anticoagulantes/farmacologíaRESUMEN
SARS-CoV-2, along with SARS-CoV and MERS-CoV, forms part of the three highly pathogenic coronaviruses identified since the start of the millennium.1,2 While SARS-CoV was identified on 2003 and MERS-CoV on 2012, the initial reports of SARS-CoV-2 (the etiological agent of COVID-19) were first released at the end of December 2019.3,4 Now, after less than four months, the virus has distributed globally and has become the focus of extensive medical research, as the number of cases keeps rising.A significant part of the investigative effort has been directed to the search for an effective therapy or intervention that could stop the spread of the disease or be used to effectively treat infected patients. Likewise, potential predisposing factors to develop a more severe clinical presentation are progressively being identified. Some of the more relevant are older age and the presence of certain comorbidities, such as cerebrovascular and coronary heart disease, hypertension and diabetes.58 It is important to highlight that the last two are chronic conditions commonly treated with ACE-inhibitors and angiotensin II type-I receptor blockers.911 However, the evidence suggests that these medications can upregulate the expression of angiotensin converting enzyme 2 (ACE2), the cellular receptor for both SARS-CoV and SARS-CoV-2.1116 Thus, a group of researchers hypothesized that ACE2-increasing drugs could raise the risk of infection and prompt a more severe clinical course or a fatal outcome in diabetic and hypertensive patients.