A drug routinely used in treating type-2 diabetes could also make those patients more susceptible to complications from COVID-19 says a report written by a UMKC School of Pharmacy researcher.

The article published in late May in the Journal of the American Pharmacists Association says the drug, captopril, was found to produce a statistically significant higher rate of pulmonary adverse drug effects compared to other drugs in its class.

Emma Stafford, Pharm.D., is the lead author of the article. Stafford worked with a group of data scientists from a collaborative known as 1Data to comb through a large source of information from national and international databases. 1Data is a partnership between UMKC and Kansas State University that has developed a platform for sharing human and animal health research data.

Stafford and her 1Data colleagues evaluated all adverse drug effects reported to the Food and Drug Administration for diabetic patients taking common front-line drugs known as ACE (angiotensin converting enzyme) inhibitors and ARBs (angiotensin-II receptor blockers).

“They were able to actually delineate diabetic patients that were taking these medications,” Stafford said. “Because pulmonary side effects are so common and so prevalent in COVID-19 patients, we were trying to ascertain if captopril, which is the oldest ACE inhibitor, might worsen someone with pulmonary issues from this disease.”

Stafford concluded in the article that going forward, pharmacists and clinicians must consider the specific adverse event profile of specific medications, particularly captopril, and how that might affect infections and other acute disease states that could alter pulmonary function, such as COVID-19.

ACE inhibitors are known to upregulate the ACE2 enzyme that is responsible for cellular entry of SARS-CoV-2. Stafford likened the effects of using captopril to a door that opens a path for the coronavirus to enter the body.

“By taking this medication, instead of having one door, you now have 20,” she said. “So, you can see that can put patients at risk.”

At the same time, Stafford said captopril also helps create a molecule that can help protect people infected with the COVID-19 virus.

“It's a really fine line and I think a lot of research is trying to toe that line and figure out which way is more predominant; is it protective or is it putting patients at risk,” Stafford said. “That was what we wanted to look at in the data. But I do think it’s early to tell exactly what effect it will have.”

Stafford is already working with a physician-researcher at the UMKC School of Medicine to look specifically at patients who have tested positive for the coronavirus and whether those on ACE inhibitors and ARBs fare worse than others not using the medications.

“These drugs are being taken for a reason,” Stafford said. “If we can help delineate these specific drugs that are a problem, it can eliminate much the confusion amongst clinicians and patients.”