ArticleNature biotechnology2021
Hypertension delays viral clearance and exacerbates airway hyperinflammation in patients with COVID-19.
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Article in Nature biotechnology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 102 papers, 4 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
102citing papers in PubMed, 4 pooled it
3.5field-weighted citation impact, top 4% of its field
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
102 citing papers in PubMed, 4 syntheses or guidelines pooled it, 180 citations in OpenAlex.
- The effects of hypertension on the prognosis of coronavirus disease 2019: a systematic review and meta-analysis on the interactions with age and antihypertensive treatment.Journal of hypertension · 2022Pooled it
- Renin-Angiotensin Aldosterone System Inhibitors and COVID-19: A Systematic Review and Meta-Analysis Revealing Critical Bias Across a Body of Observational Research.Journal of the American Heart Association · 2022Pooled it
- Causal associations between thyroid dysfunction and COVID-19 susceptibility and severity: A bidirectional Mendelian randomization study.Frontiers in endocrinology · 2022Pooled it
- COVID-19 and Cardiomyopathy: A Systematic Review.Frontiers in cardiovascular medicine · 2021Pooled it
- Telmisartan reduces systemic inflammation and alters the renin-angiotensin system in mild COVID-19.Scientific reports · 2025Trial
- A synthetic angiotensin II/ACE2-based hormone shunt controlling experimental hypertension.Nature communications · 2026Article
- Association of Chromosome 3p21.32 Haplotype Blocks Introgressed from Neanderthals with Critical COVID-19 in a Spanish Cohort.Life (Basel, Switzerland) · 2025Article
- DNA methylation changes during acute COVID-19 are associated with long-term transcriptional dysregulation in patients' airway epithelial cells.EMBO molecular medicine · 2025Article
- Omics for searching plasma biomarkers associated with unfavorable COVID-19 progression in hypertensive patients.Scientific reports · 2025Article
- Metabolic syndrome enhances SARS-CoV-2 disease severity and reduces mRNA vaccine efficacy in a mouse model.bioRxiv : the preprint server for biology · 2025Article
- Neutrophil gene expression in COVID-19 patients with acute respiratory distress syndrome.Frontiers in immunology · 2025Article
- The metabolic-immune interface of obesity in Covid-19: a role for angiotensin ii and inflammatory cytokines.Frontiers in immunology · 2025Article
- Chronic Prescription of Renin-Angiotensin-Aldosterone System Inhibitors and Hospital Outcomes in Patients with Hypertension and COVID-19.Vascular health and risk management · 2025Article
- SARS-CoV-2 pathogenesis in an angiotensin II-induced heart-on-a-chip disease model and extracellular vesicle screening.Proceedings of the National Academy of Sciences of the United States of America · 2024Article
- Immune and inflammatory mechanisms in hypertension.Nature reviews. Cardiology · 2024Review
- Pharmacological Improvement of Cystic Fibrosis Transmembrane Conductance Regulator Function Rescues Airway Epithelial Homeostasis and Host Defense in Children with Cystic Fibrosis.American journal of respiratory and critical care medicine · 2024Article
- Age-specific nasal epithelial responses to SARS-CoV-2 infection.Nature microbiology · 2024Article
- Proinflammatory cytokines driving cardiotoxicity in COVID-19.Cardiovascular research · 2024Article
- Creating cloud platforms for supporting FAIR data management in biomedical research projects.F1000Research · 2024Article
- βFrontiers in immunology · 2024Article
42 more citing papers are in PubMed but not listed here.
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Authors and funding
38 authors at 6 institutions in 2 countries.
Saskia Trump *Molecular Epidemiology Unit, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany.ORCID http://orcid.org/0000-0002-9894-1807
Soeren Lukassen *Center for Digital Health, Berlin Institute of Health (BIH) and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.ORCID http://orcid.org/0000-0001-7045-6327
Markus S Anker *Department of Cardiology, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany.
Robert Lorenz Chua *Center for Digital Health, Berlin Institute of Health (BIH) and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.ORCID http://orcid.org/0000-0001-5945-9957
Johannes Liebig *Center for Digital Health, Berlin Institute of Health (BIH) and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.ORCID http://orcid.org/0000-0002-9188-036X
Loreen Thürmann *Molecular Epidemiology Unit, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany.ORCID http://orcid.org/0000-0003-1109-1924
Victor Max Corman *Institute of Virology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany.ORCID http://orcid.org/0000-0002-3605-0136
Marco Binder *Research group 'Dynamics of early viral infection and the innate antiviral response' (division F170), German Cancer Research Center (DKFZ), Heidelberg, Germany.ORCID http://orcid.org/0000-0002-5805-6109
Jennifer LoskeMolecular Epidemiology Unit, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany.ORCID http://orcid.org/0000-0003-3222-9777
Christina KlasaInstitute for Bioinformatics, University Medicine Greifswald, Greifswald, Germany.
Teresa KriegerCenter for Digital Health, Berlin Institute of Health (BIH) and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.
Bianca P HennigCenter for Digital Health, Berlin Institute of Health (BIH) and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.ORCID http://orcid.org/0000-0002-7733-8160
Marey MessingschlagerMolecular Epidemiology Unit, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany.ORCID http://orcid.org/0000-0002-7316-8192
Fabian PottInstitute of Virology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany.ORCID http://orcid.org/0000-0003-3700-1691
Julia KazmierskiInstitute of Virology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany.ORCID http://orcid.org/0000-0002-7962-2165
Sven TwardziokCenter for Digital Health, Berlin Institute of Health (BIH) and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.
Jan Philipp AlbrechtCenter for Digital Health, Berlin Institute of Health (BIH) and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.
Jürgen EilsCenter for Digital Health, Berlin Institute of Health (BIH) and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.
Sara HadzibegovicDepartment of Cardiology, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany.
Alessia LenaDepartment of Cardiology, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany.
Bettina HeideckerDepartment of Cardiology, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany.
Thore BürgelCenter for Digital Health, Berlin Institute of Health (BIH) and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.
Jakob SteinfeldtDepartment of Cardiology, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany.ORCID http://orcid.org/0000-0003-1387-2054
Christine GoffinetInstitute of Virology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany.ORCID http://orcid.org/0000-0002-3959-004X
Florian KurthDepartment of Infectious Diseases and Respiratory Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany.ORCID http://orcid.org/0000-0002-3807-473X
Martin WitzenrathDepartment of Infectious Diseases and Respiratory Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany.
Maria Theresa VölkerDepartment of Anesthesiology and Intensive Care, University Hospital Leipzig, Leipzig, Germany.ORCID http://orcid.org/0000-0002-5267-5064
Sarah Dorothea MüllerDepartment of Anesthesiology and Intensive Care, University Hospital Leipzig, Leipzig, Germany.
Uwe Gerd LiebertInstitute of Virology, University Hospital Leipzig, Leipzig, Germany.ORCID http://orcid.org/0000-0002-5129-0875
Naveed IshaqueCenter for Digital Health, Berlin Institute of Health (BIH) and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.ORCID http://orcid.org/0000-0002-8426-901X
Lars KaderaliInstitute for Bioinformatics, University Medicine Greifswald, Greifswald, Germany.ORCID http://orcid.org/0000-0002-2359-2294
Leif-Erik SanderDepartment of Infectious Diseases and Respiratory Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany.ORCID http://orcid.org/0000-0002-0476-9947
Christian DrostenInstitute of Virology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany.ORCID http://orcid.org/0000-0001-7923-0519
Sven LaudiDepartment of Anesthesiology and Intensive Care, University Hospital Leipzig, Leipzig, Germany. sven.laudi@medizin.uni-leipzig.de.ORCID http://orcid.org/0000-0002-2117-0944
Roland EilsCenter for Digital Health, Berlin Institute of Health (BIH) and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany. roland.eils@charite.de.ORCID http://orcid.org/0000-0002-0034-4036
Christian ConradCenter for Digital Health, Berlin Institute of Health (BIH) and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany. christian.conrad@charite.de.ORCID http://orcid.org/0000-0001-7036-342X
Ulf LandmesserDepartment of Cardiology, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany. ulf.landmesser@charite.de.ORCID http://orcid.org/0000-0002-0214-3203
Irina LehmannMolecular Epidemiology Unit, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany. irina.lehmann@charite.de.ORCID http://orcid.org/0000-0001-8875-5587
Humboldt-Universität zu Berlin · DEUniversity Hospital Leipzig · DEUniversitätsmedizin Greifswald · DEGerman Cancer Research Center · DEHeidelberg University · DEUniversität Hamburg · DE
Funding
Bundesministerium für Bildung und Forschung (Federal Ministry of Education and Research) 01KX2021Bundesministerium für Bildung und Forschung (Federal Ministry of Education and Research) 031A533ABundesministerium für Bildung und Forschung (Federal Ministry of Education and Research) 031A533BBundesministerium für Bildung und Forschung (Federal Ministry of Education and Research) 031A535ABundesministerium für Bildung und Forschung (Federal Ministry of Education and Research) 031A537BBundesministerium für Bildung und Forschung (Federal Ministry of Education and Research) 031A537B, 031A533A, 031A538A, 031A533B, 031A535A, 031A537C, 031A534A, 031A532BBundesministerium für Bildung und Forschung (Federal Ministry of Education and Research) 031A537CBundesministerium für Bildung und Forschung (Federal Ministry of Education and Research) 031A538AEC | Horizon 2020 Framework Programme (EU Framework Programme for Research and Innovation H2020) 874719
Abstract
In coronavirus disease 2019 (COVID-19), hypertension and cardiovascular diseases are major risk factors for critical disease progression. However, the underlying causes and the effects of the main anti-hypertensive therapies-angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs)-remain unclear. Combining clinical data (n = 144) and single-cell sequencing data of airway samples (n = 48) with in vitro experiments, we observed a distinct inflammatory predisposition of immune cells in patients with hypertension that correlated with critical COVID-19 progression. ACEI treatment was associated with dampened COVID-19-related hyperinflammation and with increased cell intrinsic antiviral responses, whereas ARB treatment related to enhanced epithelial-immune cell interactions. Macrophages and neutrophils of patients with hypertension, in particular under ARB treatment, exhibited higher expression of the pro-inflammatory cytokines CCL3 and CCL4 and the chemokine receptor CCR1. Although the limited size of our cohort does not allow us to establish clinical efficacy, our data suggest that the clinical benefits of ACEI treatment in patients with COVID-19 who have hypertension warrant further investigation.
Indexed as
COVID-19 Drug TreatmentAdultAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsChemokine CCL3Chemokine CCL4COVID-19Disease ProgressionFemaleGene Expression RegulationHumansHypertensionInflammationMaleMiddle AgedReceptors, CCR1Angiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsCCL3 protein, humanCCL4 protein, humanCCR1 protein, humanChemokine CCL3Chemokine CCL4Receptors, CCR1
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