tetano
Editor, Senior Moderator
J Cardiol
. 2022 Apr 8;S0914-5087(22)00082-X.
doi: 10.1016/j.jjcc.2022.04.001. Online ahead of print.
Renin-angiotensin system blocker and the COVID-19 aggravation in patients with hypertension, diabetes, renal failure, Cerebro-cardiovascular disease, or pulmonary disease: Report by the COVID-19 Registry Japan
Fumiki Yoshihara[SUP] 1 [/SUP], Hiroshi Ohtsu[SUP] 2 [/SUP], Michikazu Nakai[SUP] 3 [/SUP], Shinya Tsuzuki[SUP] 4 [/SUP], Kayoko Hayakawa[SUP] 5 [/SUP], Mari Terada[SUP] 6 [/SUP], Nobuaki Matsunaga[SUP] 7 [/SUP], Satoshi Yasuda[SUP] 8 [/SUP], Hisao Ogawa[SUP] 9 [/SUP], Norio Ohmagari[SUP] 5 [/SUP]
Affiliations
Abstract
Background: The role of angiotensin-converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB) in the pandemic context of coronavirus disease 2019 (COVID-19) continues to be debated. Patients with hypertension, diabetes mellitus, chronic renal failure, cerebro-cardiovascular disease, or chronic obstructive pulmonary disease (COPD), who often use ACEi/ARB, may be at risk of severe COVID-19. However, there are no data available on the association of ACEi/ARB use with COVID-19 severity in this population.
Methods: This study is an observational study of patients with a positive severe acute respiratory syndrome coronavirus 2 test and inpatient treatment at a healthcare facility, using the registry information of COVIREGI-JP. Our primary outcomes were in-hospital death, ventilator support, extracorporeal membrane oxygenation support, and intensive care unit admission. Out of the 6055 patients, 1921 patients with preexisting hypertension, diabetes mellitus, chronic renal failure, cerebro-cardiovascular disease, or COPD were enrolled.
Results: Factors associated with an increased risk of the primary outcomes were aging, male sex, COPD, severe renal impairment, and diabetes mellitus. No correlations were observed with ACEi/ARB, cerebro-cardiovascular diseases, or hypertension. Associated factors in male patients were aging, renal impairment, hypertension, and diabetes. In female patients, factors associated with an increased risk were aging, ACEi/ARB, renal impairment, and diabetes, whereas hypertension was associated with a lower risk of the primary outcomes.
Conclusions: Independent factors for the primary outcomes were aging, male sex, COPD, severe renal impairment, and diabetes, but not ACEi/ARB. Based on this registry data analysis, more detailed data collection and analysis is needed with the cooperation of multiple healthcare facilities.
Keywords: Associated factors; COVID-19; Disease outcome.
. 2022 Apr 8;S0914-5087(22)00082-X.
doi: 10.1016/j.jjcc.2022.04.001. Online ahead of print.
Renin-angiotensin system blocker and the COVID-19 aggravation in patients with hypertension, diabetes, renal failure, Cerebro-cardiovascular disease, or pulmonary disease: Report by the COVID-19 Registry Japan
Fumiki Yoshihara[SUP] 1 [/SUP], Hiroshi Ohtsu[SUP] 2 [/SUP], Michikazu Nakai[SUP] 3 [/SUP], Shinya Tsuzuki[SUP] 4 [/SUP], Kayoko Hayakawa[SUP] 5 [/SUP], Mari Terada[SUP] 6 [/SUP], Nobuaki Matsunaga[SUP] 7 [/SUP], Satoshi Yasuda[SUP] 8 [/SUP], Hisao Ogawa[SUP] 9 [/SUP], Norio Ohmagari[SUP] 5 [/SUP]
Affiliations
- PMID: 35469713
- DOI: 10.1016/j.jjcc.2022.04.001
Abstract
Background: The role of angiotensin-converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB) in the pandemic context of coronavirus disease 2019 (COVID-19) continues to be debated. Patients with hypertension, diabetes mellitus, chronic renal failure, cerebro-cardiovascular disease, or chronic obstructive pulmonary disease (COPD), who often use ACEi/ARB, may be at risk of severe COVID-19. However, there are no data available on the association of ACEi/ARB use with COVID-19 severity in this population.
Methods: This study is an observational study of patients with a positive severe acute respiratory syndrome coronavirus 2 test and inpatient treatment at a healthcare facility, using the registry information of COVIREGI-JP. Our primary outcomes were in-hospital death, ventilator support, extracorporeal membrane oxygenation support, and intensive care unit admission. Out of the 6055 patients, 1921 patients with preexisting hypertension, diabetes mellitus, chronic renal failure, cerebro-cardiovascular disease, or COPD were enrolled.
Results: Factors associated with an increased risk of the primary outcomes were aging, male sex, COPD, severe renal impairment, and diabetes mellitus. No correlations were observed with ACEi/ARB, cerebro-cardiovascular diseases, or hypertension. Associated factors in male patients were aging, renal impairment, hypertension, and diabetes. In female patients, factors associated with an increased risk were aging, ACEi/ARB, renal impairment, and diabetes, whereas hypertension was associated with a lower risk of the primary outcomes.
Conclusions: Independent factors for the primary outcomes were aging, male sex, COPD, severe renal impairment, and diabetes, but not ACEi/ARB. Based on this registry data analysis, more detailed data collection and analysis is needed with the cooperation of multiple healthcare facilities.
Keywords: Associated factors; COVID-19; Disease outcome.