Pulmonary Adverse Event Data in Hypertension with Implications on COVID-19 Morbidity

Hypertension is a recognized comorbidity for COVID-19. The contribution of medications to COVID-19 morbidity in hypertensive patients is unknown; however, ACE2, responsible for SARS-CoV-2 cell entry, is upregulated in patients taking ACEI and ARB antihypertensive drugs. Here, we evaluated prevalence of pulmonary adverse drug events (ADEs) in hypertensive patients receiving ACEIs/ARBs to help elucidate how these medications may affect clinical outcomes in acute respiratory illnesses. ADEs reported to the FDA’s Adverse Event Reporting System for hypertensive patients taking ACEI or ARB drugs show a cluster of pulmonary symptoms potentially exacerbating symptoms in COVID-19 patients. We found that retrospective analysis of 13 predominant pulmonary ADEs showed significant differences in ADEs associated with Quinapril and Trandolapril, compared to all other ACEIs and all ARBs. This study suggests that specific members of the ACEI hypertensive class (Quinapril and Trandolapril) have a cluster of pulmonary ADEs which could impact the management of COVID-19 patients.