tetano
Editor, Senior Moderator
BMC Infect Dis
. 2021 Mar 15;21(1):262.
doi: 10.1186/s12879-021-05951-w.
Renin-angiotensin system inhibitors and susceptibility to COVID-19 in patients with hypertension: a propensity score-matched cohort study in primary care
Shamil Haroon[SUP] #[/SUP][SUP] 1 [/SUP], Anuradhaa Subramanian[SUP] #[/SUP][SUP] 1 [/SUP], Jennifer Cooper[SUP] 1 [/SUP], Astha Anand[SUP] 1 [/SUP], Krishna Gokhale[SUP] 1 [/SUP], Nathan Byne[SUP] 2 [/SUP], Samir Dhalla[SUP] 3 [/SUP], Dionisio Acosta-Mena[SUP] 2 [/SUP], Thomas Taverner[SUP] 1 [/SUP], Kelvin Okoth[SUP] 1 [/SUP], Jingya Wang[SUP] 1 [/SUP], Joht Singh Chandan[SUP] 1 [/SUP], Christopher Sainsbury[SUP] 1 4 [/SUP], Dawit Tefra Zemedikun[SUP] 1 [/SUP], G Neil Thomas[SUP] 1 [/SUP], Dhruv Parekh[SUP] 5 6 [/SUP], Tom Marshall[SUP] 1 [/SUP], Elizabeth Sapey[SUP] 5 6 7 [/SUP], Nicola J Adderley[SUP] 8 [/SUP], Krishnarajah Nirantharakumar[SUP] 1 9 10 [/SUP]
Affiliations
Abstract
Introduction: Renin-angiotensin system (RAS) inhibitors have been postulated to influence susceptibility to Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). This study investigated whether there is an association between their prescription and the incidence of COVID-19 and all-cause mortality.
Methods: We conducted a propensity-score matched cohort study comparing the incidence of COVID-19 among patients with hypertension prescribed angiotensin-converting enzyme I (ACE) inhibitors or angiotensin II type-1 receptor blockers (ARBs) to those treated with calcium channel blockers (CCBs) in a large UK-based primary care database (The Health Improvement Network). We estimated crude incidence rates for confirmed/suspected COVID-19 in each drug exposure group. We used Cox proportional hazards models to produce adjusted hazard ratios for COVID-19. We assessed all-cause mortality as a secondary outcome.
Results: The incidence rate of COVID-19 among users of ACE inhibitors and CCBs was 9.3 per 1000 person-years (83 of 18,895 users [0.44%]) and 9.5 per 1000 person-years (85 of 18,895 [0.45%]), respectively. The adjusted hazard ratio was 0.92 (95% CI 0.68 to 1.26). The incidence rate among users of ARBs was 15.8 per 1000 person-years (79 out of 10,623 users [0.74%]). The adjusted hazard ratio was 1.38 (95% CI 0.98 to 1.95). There were no significant associations between use of RAS inhibitors and all-cause mortality.
Conclusion: Use of ACE inhibitors was not associated with the risk of COVID-19 whereas use of ARBs was associated with a statistically non-significant increase compared to the use of CCBs. However, no significant associations were observed between prescription of either ACE inhibitors or ARBs and all-cause mortality.
. 2021 Mar 15;21(1):262.
doi: 10.1186/s12879-021-05951-w.
Renin-angiotensin system inhibitors and susceptibility to COVID-19 in patients with hypertension: a propensity score-matched cohort study in primary care
Shamil Haroon[SUP] #[/SUP][SUP] 1 [/SUP], Anuradhaa Subramanian[SUP] #[/SUP][SUP] 1 [/SUP], Jennifer Cooper[SUP] 1 [/SUP], Astha Anand[SUP] 1 [/SUP], Krishna Gokhale[SUP] 1 [/SUP], Nathan Byne[SUP] 2 [/SUP], Samir Dhalla[SUP] 3 [/SUP], Dionisio Acosta-Mena[SUP] 2 [/SUP], Thomas Taverner[SUP] 1 [/SUP], Kelvin Okoth[SUP] 1 [/SUP], Jingya Wang[SUP] 1 [/SUP], Joht Singh Chandan[SUP] 1 [/SUP], Christopher Sainsbury[SUP] 1 4 [/SUP], Dawit Tefra Zemedikun[SUP] 1 [/SUP], G Neil Thomas[SUP] 1 [/SUP], Dhruv Parekh[SUP] 5 6 [/SUP], Tom Marshall[SUP] 1 [/SUP], Elizabeth Sapey[SUP] 5 6 7 [/SUP], Nicola J Adderley[SUP] 8 [/SUP], Krishnarajah Nirantharakumar[SUP] 1 9 10 [/SUP]
Affiliations
- PMID: 33722197
- DOI: 10.1186/s12879-021-05951-w
Abstract
Introduction: Renin-angiotensin system (RAS) inhibitors have been postulated to influence susceptibility to Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). This study investigated whether there is an association between their prescription and the incidence of COVID-19 and all-cause mortality.
Methods: We conducted a propensity-score matched cohort study comparing the incidence of COVID-19 among patients with hypertension prescribed angiotensin-converting enzyme I (ACE) inhibitors or angiotensin II type-1 receptor blockers (ARBs) to those treated with calcium channel blockers (CCBs) in a large UK-based primary care database (The Health Improvement Network). We estimated crude incidence rates for confirmed/suspected COVID-19 in each drug exposure group. We used Cox proportional hazards models to produce adjusted hazard ratios for COVID-19. We assessed all-cause mortality as a secondary outcome.
Results: The incidence rate of COVID-19 among users of ACE inhibitors and CCBs was 9.3 per 1000 person-years (83 of 18,895 users [0.44%]) and 9.5 per 1000 person-years (85 of 18,895 [0.45%]), respectively. The adjusted hazard ratio was 0.92 (95% CI 0.68 to 1.26). The incidence rate among users of ARBs was 15.8 per 1000 person-years (79 out of 10,623 users [0.74%]). The adjusted hazard ratio was 1.38 (95% CI 0.98 to 1.95). There were no significant associations between use of RAS inhibitors and all-cause mortality.
Conclusion: Use of ACE inhibitors was not associated with the risk of COVID-19 whereas use of ARBs was associated with a statistically non-significant increase compared to the use of CCBs. However, no significant associations were observed between prescription of either ACE inhibitors or ARBs and all-cause mortality.