Drug treatments affecting ACE2 in COVID-19 infection: a systematic review protocol
Drug treatments affecting ACE2 in COVID-19 infection: a systematic review protocol
BACKGROUND: The SARS-CoV-2 virus causing COVID-19 binds human angiotensin-converting enzyme 2 (ACE2) receptors in human tissues. ACE2 expression may be associated with COVID-19 infection and mortality rates. Routinely prescribed drugs that up- or down-regulate ACE2 expression are, therefore, of critical research interest as agents that might promote or reduce risk of COVID-19 infection in a susceptible population.
AIM: To collate evidence on routinely prescribed drug treatments in the UK that could up- or down-regulate ACE2, and thus potentially affect COVID-19 infection.
DESIGN & SETTING: Systematic review of studies published in MEDLINE, Embase, CINAHL (Cumulative Index to Nursing and Allied Health Literature), the Cochrane Library, and Web of Science from inception to 1 April 2020.
METHOD: A systematic review will be conducted in line with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Inclusion criteria will be: (1) assesses the effect of drug exposure on ACE2 level of expression or activity; (2) the drug is included in the British National Formulary (BNF) and, therefore, available to prescribe in the UK; and (3) a control, placebo, or sham group is included as comparator. Exclusion criteria will be: (1) ACE2 measurement in utero; (2) ACE2 measurement in children aged <18 years; (3) drug not in the BNF; and (4) review article. Quality will be assessed using the Cochrane risk of bias tool for human studies, and the SYstematic Review Center for Laboratory animal Experimentation (SYRCLE) risk of bias tool for animal studies.
RESULTS: Data will be reported in summary tables and narrative synthesis.
CONCLUSION: This systematic review will identify drug therapies that may increase or decrease ACE2 expression. This might identify medications increasing risk of COVID-19 transmission, or as targets for intervention in mitigating transmission.
ace-i, covid-19, drug therapy, review
Dambha-Miller, Hajira
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Albasri, Ali
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Hodgson, Sam
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Wilcox, Christopher
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Islam, Nazrul
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Khan, Shareen
5c9b2dec-1679-437f-ab52-103b2ff1d2fa
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Griffin, Simon
82ce3f76-cd32-4125-8b46-0cae8f1e2278
1 August 2020
Dambha-Miller, Hajira
58961db5-31aa-460e-9394-08590c4b7ba1
Albasri, Ali
733fe375-5968-4d4b-a50a-30c4ceeec8b5
Hodgson, Sam
bc059529-009b-4f80-94b7-d5211a175eee
Wilcox, Christopher
e2c4c36a-e2e5-43a5-9fd6-7198cc15dd53
Islam, Nazrul
e5345196-7479-438f-b4f6-c372d2135586
Khan, Shareen
5c9b2dec-1679-437f-ab52-103b2ff1d2fa
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Griffin, Simon
82ce3f76-cd32-4125-8b46-0cae8f1e2278
Dambha-Miller, Hajira, Albasri, Ali, Hodgson, Sam, Wilcox, Christopher, Islam, Nazrul, Khan, Shareen, Little, Paul and Griffin, Simon
(2020)
Drug treatments affecting ACE2 in COVID-19 infection: a systematic review protocol.
BJGP Open, 4 (3), [bjgpopen20X101115].
(doi:10.3399/bjgpopen20X101115).
Abstract
BACKGROUND: The SARS-CoV-2 virus causing COVID-19 binds human angiotensin-converting enzyme 2 (ACE2) receptors in human tissues. ACE2 expression may be associated with COVID-19 infection and mortality rates. Routinely prescribed drugs that up- or down-regulate ACE2 expression are, therefore, of critical research interest as agents that might promote or reduce risk of COVID-19 infection in a susceptible population.
AIM: To collate evidence on routinely prescribed drug treatments in the UK that could up- or down-regulate ACE2, and thus potentially affect COVID-19 infection.
DESIGN & SETTING: Systematic review of studies published in MEDLINE, Embase, CINAHL (Cumulative Index to Nursing and Allied Health Literature), the Cochrane Library, and Web of Science from inception to 1 April 2020.
METHOD: A systematic review will be conducted in line with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Inclusion criteria will be: (1) assesses the effect of drug exposure on ACE2 level of expression or activity; (2) the drug is included in the British National Formulary (BNF) and, therefore, available to prescribe in the UK; and (3) a control, placebo, or sham group is included as comparator. Exclusion criteria will be: (1) ACE2 measurement in utero; (2) ACE2 measurement in children aged <18 years; (3) drug not in the BNF; and (4) review article. Quality will be assessed using the Cochrane risk of bias tool for human studies, and the SYstematic Review Center for Laboratory animal Experimentation (SYRCLE) risk of bias tool for animal studies.
RESULTS: Data will be reported in summary tables and narrative synthesis.
CONCLUSION: This systematic review will identify drug therapies that may increase or decrease ACE2 expression. This might identify medications increasing risk of COVID-19 transmission, or as targets for intervention in mitigating transmission.
Text
bjgpopen20X101115.full
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More information
Accepted/In Press date: 7 June 2020
e-pub ahead of print date: 15 July 2020
Published date: 1 August 2020
Additional Information:
Funding Information:
The Southampton, Cambridge and Oxford Primary Care Departments are members of the NIHR School for Primary Care Research and supported by NIHR Research funds. The University of Cambridge has received salary support in respect of SJG from the NHS in the East of England through the Clinical Academic Reserve. SJG is supported by an MRC Epidemiology Unit programme: MC_ UU_12015/4. HDM is an NIHR Clinical Lecturer and supported by an NIHR SPCR grant for this work: SPCR2014-10043. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.
Funding Information:
HDM had no involvement in the peer review process or decision on this manuscript. SG reports grants from Wellcome Trust, Medical Research Council, NIHR, NIHR Health Technology Assessment Programme, NHS R&D, and the University of Aarhus (Denmark), and provision of equipment from Bio-Rad during the conduct of the study. Outside the submitted work, he also reports receiving fees from Novo Nordisk, Astra Zeneca and Napp for speaking at postgraduate education meetings, support to attend a scientific meeting from Napp, and an honorarium and reimbursement of travel expenses from Eli Lilly associated with membership of an independent data monitoring committee for a randomised trial of a medication to lower glucose. No other authors have any competing interests to declare.
Publisher Copyright:
© 2020, The Authors.
Keywords:
ace-i, covid-19, drug therapy, review
Identifiers
Local EPrints ID: 443052
URI: http://eprints.soton.ac.uk/id/eprint/443052
PURE UUID: 9e72324e-d8e6-4d33-ac65-7e221dbb6950
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Date deposited: 07 Aug 2020 16:30
Last modified: 12 Jul 2024 02:12
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Contributors
Author:
Ali Albasri
Author:
Sam Hodgson
Author:
Nazrul Islam
Author:
Shareen Khan
Author:
Simon Griffin
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