tetano
Editor, Senior Moderator
Aging (Albany NY)
. 2021 Apr 22;13.
doi: 10.18632/aging.202902. Online ahead of print.
Does taking an angiotensin inhibitor increase the risk for COVID-19? - a systematic review and meta-analysis
Zheng Ma[SUP] 1 [/SUP], Mei-Ping Wang[SUP] 2 [/SUP], Lian Liu[SUP] 3 [/SUP], Shuang Yu[SUP] 4 [/SUP], Tian-Ran Wu[SUP] 5 [/SUP], Lei Zhao[SUP] 1 [/SUP], Ye-Ping Zhang[SUP] 1 [/SUP], Hai-Feng Liang[SUP] 6 [/SUP], Xin-Chun Yang[SUP] 1 [/SUP]
Affiliations
Abstract
Because SARS-COV2 entry into cells is dependent on angiotensin converting enzyme 2 (ACE2) and angiotensin converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) increase ACE2 activity, the safety of ACEI/ARB usage during the coronavirus disease 2019 (COVID-19) pandemic is a controversial topic. To address that issue, we performed a meta-analysis following The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Searches of the Embase, MEDLINE, PubMed, and Cochrane Library databases identified 16 case-control studies examining the effect of ACEI/ARB on the incidence of COVID-19 and its severity. ACEI/ARB usage was associated with an increased risk of COVID-19 morbidity (odds ratio (OR) 1.20, 95% confidence interval (CI) 1.07-1.33, P=0.001) among the general population but not in a hypertensive population (OR 1.05, 95% CI 0.90-1.21, P=0.553). ACEI/ARB usage was not associated with an increased risk of COVID-19 morbidity (coefficient 1.00, 95% CI 1.00-1.00, P=0.660) when we adjusted for hypertension in the general population. ACEI/ARB usage was also not associated with an increased risk of severe illness (OR 0.90, 95%CI 0.55-1.47, P=0.664) or mortality (OR 1.43, 95%CI 0.97-2.10, P=0.070) in COVID-19 patients. Our meta-analysis revealed that ACEI/ARB usage was not associated with either the increased risk of SARS-COV2 infection or the adverse outcomes in COVID-19 patients.
Keywords: COVID-19; angiotensin converting enzyme inhibitors; angiotensin receptor blockers; angiotensin-converting enzyme 2; coronavirus disease 2019.
. 2021 Apr 22;13.
doi: 10.18632/aging.202902. Online ahead of print.
Does taking an angiotensin inhibitor increase the risk for COVID-19? - a systematic review and meta-analysis
Zheng Ma[SUP] 1 [/SUP], Mei-Ping Wang[SUP] 2 [/SUP], Lian Liu[SUP] 3 [/SUP], Shuang Yu[SUP] 4 [/SUP], Tian-Ran Wu[SUP] 5 [/SUP], Lei Zhao[SUP] 1 [/SUP], Ye-Ping Zhang[SUP] 1 [/SUP], Hai-Feng Liang[SUP] 6 [/SUP], Xin-Chun Yang[SUP] 1 [/SUP]
Affiliations
- PMID: 33886504
- DOI: 10.18632/aging.202902
Abstract
Because SARS-COV2 entry into cells is dependent on angiotensin converting enzyme 2 (ACE2) and angiotensin converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) increase ACE2 activity, the safety of ACEI/ARB usage during the coronavirus disease 2019 (COVID-19) pandemic is a controversial topic. To address that issue, we performed a meta-analysis following The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Searches of the Embase, MEDLINE, PubMed, and Cochrane Library databases identified 16 case-control studies examining the effect of ACEI/ARB on the incidence of COVID-19 and its severity. ACEI/ARB usage was associated with an increased risk of COVID-19 morbidity (odds ratio (OR) 1.20, 95% confidence interval (CI) 1.07-1.33, P=0.001) among the general population but not in a hypertensive population (OR 1.05, 95% CI 0.90-1.21, P=0.553). ACEI/ARB usage was not associated with an increased risk of COVID-19 morbidity (coefficient 1.00, 95% CI 1.00-1.00, P=0.660) when we adjusted for hypertension in the general population. ACEI/ARB usage was also not associated with an increased risk of severe illness (OR 0.90, 95%CI 0.55-1.47, P=0.664) or mortality (OR 1.43, 95%CI 0.97-2.10, P=0.070) in COVID-19 patients. Our meta-analysis revealed that ACEI/ARB usage was not associated with either the increased risk of SARS-COV2 infection or the adverse outcomes in COVID-19 patients.
Keywords: COVID-19; angiotensin converting enzyme inhibitors; angiotensin receptor blockers; angiotensin-converting enzyme 2; coronavirus disease 2019.