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Calcium channel blocker amlodipine besylate is associated with reduced case fatality rate of COVID-19 patients with hypertension

By Lei-Ke Zhang, Yuan Sun, Haolong Zeng, Yudong Peng, Xiaming Jiang, Wei-Juan Shang, Yan Wu, Shufen Li, Yu-Lan Zhang, Liu Yang, Hongbo Chen, Runming Jin, Wei Liu, Hao Li, Ke Peng, Gengfu Xiao

Posted 14 Apr 2020
medRxiv DOI: 10.1101/2020.04.08.20047134

The coronavirus disease (COVID-19) caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has now spread to more than 100 countries posing as a serious threat to the public health on a global scale. Patients with comorbidity such as hypertension suffer more severe infection with elevated case fatality rate. Development of effective anti-viral drug is in urgent need to treat COVID-19 patients. Here we report that calcium channel blockers (CCBs), a type of anti-hypertension drugs that are widely used in the clinics, can significantly inhibit the post-entry replication events of SARS-CoV-2 in vitro. Comparison with two other major types of anti-hypertension drugs, the angiotensin converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARB), showed that only CCBs display significant anti-SARS-CoV-2 efficacy. Combined treatment with chloroquine and CCBs significantly enhanced the anti-SARS-CoV-2 efficacy. Retrospective clinical investigation of COVID-19 patients revealed that the CCB amlodipine besylate administration was associated with reduced case fatality rate of patients with hypertension. Results from this study suggest that CCB administration for COVID-19 patients with hypertension as the comorbidity might improve the disease outcome.

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