• Kwadwo Ofosu-Barko, Yi Liu, Faisal Alkhatib Tamimi, Wael Al Husami, Sarju Ganatra, Frederic Resnic, and Sachin P Shah.
• From the Department of Medicine, Lahey Hospital and Medical Center, Burlington, MA.
• Crit Pathw Cardiol. 2021 Jun 1; 20 (2): 100-102.

PurposeTo understand the hemodynamic effect of angiotensin II as a vasopressor in patients with shock secondary to COVID-19 infection.MethodsA retrospective analysis was performed on all patients at a single center with COVID-19 infection and shock who were treated with angiotensin II. The hemodynamic response to angiotensin II was estimated by recording the mean arterial pressure, norepinephrine equivalent dose (NED) and urine output.ResultsTen patients with COVID-19 related shock were treated with angiotensin II. Over the initial 6 hours, the average the NED decreased by 30.4% (from 64.6 to 44 µg/min) without a significant change in the mean arterial pressure (0.7% decrease). Six patients experienced at least a 25% reduction in NED by 6 hours, and 2 experienced at least a 50% reduction.ConclusionsOn average, the hemodynamic response to angiotensin II in COVID-19 related shock was favorable. Two patients had a marked rapid improvement. Given the relationship of SARS-CoV-2 with the renin-angiotensin-aldosterone system, further evaluation of angiotensin II for the treatment of COVID-19 related shock is warranted.Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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