Unexpected BP Sensitivity to Angiotensin II in a Patient With Coronavirus Disease 2019, ARDS, and Septic Shock

Chest. 2020 Aug;158(2):e55-e58. doi: 10.1016/j.chest.2020.04.015. Epub 2020 Apr 23.

Abstract

We report the case of an 88-year-old man with coronavirus disease 2019 (COVID-19) who presented with ARDS and septic shock. The patient had exquisite BP sensitivity to low-dose angiotensin II (Ang-2), allowing for rapid liberation from high-dose vasopressors. We hypothesize that sensitivity to Ang-2 might be related to biological effect of severe acute respiratory syndrome coronavirus 2 infection. The case is suggestive of a potential role for synthetic Ang-2 for patients with COVID-19 and septic shock. Further studies are needed to confirm our observed clinical efficacy.

Keywords: COVID-19; SARS-CoV-2; angiotensin II; septic shock.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Angiotensin II / drug effects
  • Angiotensin II / metabolism*
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
  • Betacoronavirus
  • COVID-19
  • Coronavirus Infections / complications
  • Coronavirus Infections / drug therapy*
  • Coronavirus Infections / metabolism
  • Humans
  • Male
  • Pandemics
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / drug therapy*
  • Pneumonia, Viral / metabolism
  • Respiratory Distress Syndrome / drug therapy*
  • Respiratory Distress Syndrome / etiology
  • SARS-CoV-2
  • Shock, Septic / complications
  • Shock, Septic / drug therapy*
  • Shock, Septic / metabolism

Substances

  • Angiotensin-Converting Enzyme Inhibitors
  • Angiotensin II