tetano
Editor, Senior Moderator
Cardiovasc Hematol Disord Drug Targets
. 2022 Apr 20.
doi: 10.2174/1871529X22666220420112735. Online ahead of print.
Pre-admission beta-blocker therapy and outcomes of coronavirus disease 2019 (COVID-19): A systematic review, meta-analysis, and meta-regression
Timotius Ivan Hariyanto[SUP] 1 [/SUP], Joshua Edward Hananto[SUP] 1 [/SUP], Denny Intan[SUP] 1 [/SUP], Andree Kurniawan[SUP] 2 [/SUP]
Affiliations
Abstract
Background: Hypertension and heart failure are known risk factors for coronavirus disease 2019 (COVID-19) severity and mortality outcomes. Beta-blocker is one of the drugs of choice to treat these conditions. The purpose of this study is to explore the relationship between pre-admission beta-blocker use and COVID-19 outcomes.
Methods: PubMed and Europe PMC were used as the database for our search strategy by using combined keywords related to our aims until December 10th, 2020. All articles related to COVID-19 and beta-blocker were retrieved. Review Manager 5.4 and Comprehensive Meta-Analysis 3 software were used to perform statistical analysis.
Results: A total of 43 studies consisting of 11,388,556 patients were included in our analysis. Our meta-analysis showed that the use of beta-blocker was associated with increased risk of COVID-19 [OR 1.32 (95% CI 1.02 - 1.70), p = 0.03, I2 = 99%, random-effect modelling], clinical progression [OR 1.37 (95% CI 1.01 - 1.88), p = 0.04, I2 = 89%, random-effect modelling], and mortality from COVID-19 [OR 1.64 (95% CI 1.22 - 2.19), p = 0.0009, I2 = 94%, random-effect modelling]. Meta-regression showed that the association with mortality outcome were influenced by age (p = 0.018) and hypertension (p = 0.005).
Conclusions: The risk and benefits of using beta-blocker as a drug of choice to treat hypertensive patients should be put into account and reviewed individually case by case, knowing their association in higher incidence and severity of Covid-19 infections. Other first-line antihypertensive drugs may be considered as an alternative therapy if the risk of administering beta blockers outweigh the benefits in Covid-19 infection.
Keywords: COVID-19; beta-blocker; hypertension; cardiovascular; coronavirus disease 2019; heart failure; treatment.
. 2022 Apr 20.
doi: 10.2174/1871529X22666220420112735. Online ahead of print.
Pre-admission beta-blocker therapy and outcomes of coronavirus disease 2019 (COVID-19): A systematic review, meta-analysis, and meta-regression
Timotius Ivan Hariyanto[SUP] 1 [/SUP], Joshua Edward Hananto[SUP] 1 [/SUP], Denny Intan[SUP] 1 [/SUP], Andree Kurniawan[SUP] 2 [/SUP]
Affiliations
- PMID: 35450537
- DOI: 10.2174/1871529X22666220420112735
Abstract
Background: Hypertension and heart failure are known risk factors for coronavirus disease 2019 (COVID-19) severity and mortality outcomes. Beta-blocker is one of the drugs of choice to treat these conditions. The purpose of this study is to explore the relationship between pre-admission beta-blocker use and COVID-19 outcomes.
Methods: PubMed and Europe PMC were used as the database for our search strategy by using combined keywords related to our aims until December 10th, 2020. All articles related to COVID-19 and beta-blocker were retrieved. Review Manager 5.4 and Comprehensive Meta-Analysis 3 software were used to perform statistical analysis.
Results: A total of 43 studies consisting of 11,388,556 patients were included in our analysis. Our meta-analysis showed that the use of beta-blocker was associated with increased risk of COVID-19 [OR 1.32 (95% CI 1.02 - 1.70), p = 0.03, I2 = 99%, random-effect modelling], clinical progression [OR 1.37 (95% CI 1.01 - 1.88), p = 0.04, I2 = 89%, random-effect modelling], and mortality from COVID-19 [OR 1.64 (95% CI 1.22 - 2.19), p = 0.0009, I2 = 94%, random-effect modelling]. Meta-regression showed that the association with mortality outcome were influenced by age (p = 0.018) and hypertension (p = 0.005).
Conclusions: The risk and benefits of using beta-blocker as a drug of choice to treat hypertensive patients should be put into account and reviewed individually case by case, knowing their association in higher incidence and severity of Covid-19 infections. Other first-line antihypertensive drugs may be considered as an alternative therapy if the risk of administering beta blockers outweigh the benefits in Covid-19 infection.
Keywords: COVID-19; beta-blocker; hypertension; cardiovascular; coronavirus disease 2019; heart failure; treatment.