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Leisman DE, Mastroianni F, Fisler G, et al. Physiologic Response to Angiotensin II Treatment for Coronavirus Disease 2019-Induced Vasodilatory Shock: A Retrospective Matched Cohort Study. Crit Care Explor. 2020;2(10):e0230doi: 10.1097/CCE.0000000000000230.
Leisman, D. E., Mastroianni, F., Fisler, G., Shah, S., Hasan, Z., Narasimhan, M., Taylor, M. D., & Deutschman, C. S. (2020). Physiologic Response to Angiotensin II Treatment for Coronavirus Disease 2019-Induced Vasodilatory Shock: A Retrospective Matched Cohort Study. Critical care explorations, 2(10), e0230. https://doi.org/10.1097/CCE.0000000000000230
Leisman, Daniel E, et al. "Physiologic Response to Angiotensin II Treatment for Coronavirus Disease 2019-Induced Vasodilatory Shock: A Retrospective Matched Cohort Study." Critical care explorations vol. 2,10 (2020): e0230. doi: https://doi.org/10.1097/CCE.0000000000000230
Leisman DE, Mastroianni F, Fisler G, Shah S, Hasan Z, Narasimhan M, Taylor MD, Deutschman CS. Physiologic Response to Angiotensin II Treatment for Coronavirus Disease 2019-Induced Vasodilatory Shock: A Retrospective Matched Cohort Study. Crit Care Explor. 2020 Sep 29;2(10):e0230. doi: 10.1097/CCE.0000000000000230. eCollection 2020 Oct. PMID: 33063034; PMCID: PMC7523856.
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Crit Care Explor. 2020 Sep 29;2(10):e0230. doi: 10.1097/CCE.0000000000000230. eCollection 2020 Oct.

Physiologic Response to Angiotensin II Treatment for Coronavirus Disease 2019-Induced Vasodilatory Shock: A Retrospective Matched Cohort Study.

Critical care explorations

Daniel E Leisman, Fiore Mastroianni, Grace Fisler, Sareen Shah, Zubair Hasan, Mangala Narasimhan, Matthew D Taylor, Clifford S Deutschman

Affiliations

  1. Department of Medicine, Massachusetts General Hospital, Boston, MA.
  2. Sepsis Research Laboratory, Feinstein Institute for Medical Research, Manhasset, NY.
  3. Division of Pulmonary and Critical Care Medicine, Northwell Health, New Hyde Park, NY.
  4. Zucker School of Medicine at Hofstra-Northwell, Hempstead, NY.
  5. Division of Critical Care Medicine, Department of Pediatrics, Cohen Children's Medical Center, New Hyde Park, NY.

PMID: 33063034 PMCID: PMC7523856 DOI: 10.1097/CCE.0000000000000230

Abstract

OBJECTIVES: To assess the early physiologic response to angiotensin-II treatment in patients with coronavirus disease 2019-induced respiratory failure and distributive shock.

DESIGN: Retrospective consecutive-sample cohort study.

SETTING: Three medical ICUs in New York during the coronavirus disease 2019 outbreak.

PATIENTS: All patients were admitted to the ICU with respiratory failure and were receiving norepinephrine for distributive shock.

INTERVENTIONS: The treatment groups were patients who received greater than or equal to 1 hour of angiotensin-II treatment. Time-zero was the time of angiotensin-II initiation. Controls were identified using a 2:1 hierarchical process that matched for 1) date and unit of admission; 2) specific organ support modalities; 3) age; 4) chronic lung, cardiovascular, and kidney disease; and 5) sex. Time-zero in the control group was 21 hours post vasopressor initiation, the mean duration of vasopressor therapy prior to angiotensin-II initiation in the treated group.

MEASUREMENTS AND MAIN RESULTS: Main outcomes were trajectories of vasopressor requirements (in norepinephrine-equivalent dose) and mean arterial pressure. Additionally assessed trajectories were respiratory (Pao

CONCLUSIONS: Angiotensin-II treatment for coronavirus disease 2019-induced distributive shock was associated with rapid improvement in multiple physiologic indices. Angiotensin-II in coronavirus disease 2019-induced shock warrants further study.

Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.

Keywords: angiotensin II; coronavirus disease 2019; norepinephrine; severe acute respiratory syndrome coronavirus-2 infection; shock; vasoconstrictor agents

Conflict of interest statement

Dr. Leisman discloses that La Jolla Pharmaceutical Company, the manufacturer of Giapreza, provided a sample of their drug free of charge for mouse experiments that are not related to the present study

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