tetano
Editor, Senior Moderator
J Cardiovasc Thorac Res
. 2022;14(4):253-257.
doi: 10.34172/jcvtr.2022.30559. Epub 2022 Nov 26.
Effects of angiotensin receptor blockers (ARBs) on clinical outcomes of patients with hypertension and COVID-19: A 7-month follow-up cohort study
Azar Hadadi[SUP] 1 [/SUP], Sina Kazemian[SUP] 2 [/SUP], Mahan Shafie[SUP] 3 4 [/SUP], Arezoo Ahmadi[SUP] 5 [/SUP], Abbas Soleimani[SUP] 6 [/SUP], Haleh Ashraf[SUP] 2 7 [/SUP]
Affiliations
Abstract
Introduction: Since the coronavirus disease 2019 (COVID-19) pandemic, the use of angiotensin II receptor blockers (ARBs) in hypertensive patients with COVID-19 has been controversial. Following our previous study, after one year, we intended to extend our sample size and results to investigate the effects of ARBs with both in-hospital outcomes and 7-month follow-up results in patients with COVID-19. Methods: Patients with a diagnosis of COVID-19 who were admitted to Sina Hospital, Tehran, Iran, from February to October 2020 participated in this follow-up cohort study. The COVID-19 diagnosis was based on a positive polymerase chain reaction test or chest computed tomography scan according to guidelines. Patients were followed for disease severity, incurring in-hospital mortality, complications, and 7-month all-cause mortality. Results: We evaluated 1413 patients with COVID-19 in this study. After excluding 124 patients, 1289 including 561(43.5%) hypertensive patients, entered the analysis. During the study, 875(67.9%) severe disease, 227(17.6%) in-hospital mortality, and 307(23.8%) 7-month all-cause mortality were observed. After adjusting for possible confounders, ARB was not associated with severity, in-hospital and 7-month all-cause mortality, and in-hospital complications except for acute kidney injury. Discontinuation of ARBs was significantly associated with higher in-hospital mortality and 7-month all-cause mortality (both P values<0.006). We observed a better 7-month outcome in those who continued their ARBs after discharge. Conclusion: The results of this study, along with the previous studies, provide reassurance that taking ARBs is not associated with the risk of mortality, complications, and poorer outcomes in hypertensive COVID-19 patients after adjustment for possible confounders.
Keywords: Angiotensin-Converting Enzyme Inhibitors; COVID-19; Hypertension; Renin-Angiotensin System; SARS-CoV-2.
. 2022;14(4):253-257.
doi: 10.34172/jcvtr.2022.30559. Epub 2022 Nov 26.
Effects of angiotensin receptor blockers (ARBs) on clinical outcomes of patients with hypertension and COVID-19: A 7-month follow-up cohort study
Azar Hadadi[SUP] 1 [/SUP], Sina Kazemian[SUP] 2 [/SUP], Mahan Shafie[SUP] 3 4 [/SUP], Arezoo Ahmadi[SUP] 5 [/SUP], Abbas Soleimani[SUP] 6 [/SUP], Haleh Ashraf[SUP] 2 7 [/SUP]
Affiliations
- PMID: 36699557
- PMCID: PMC9871165
- DOI: 10.34172/jcvtr.2022.30559
Abstract
Introduction: Since the coronavirus disease 2019 (COVID-19) pandemic, the use of angiotensin II receptor blockers (ARBs) in hypertensive patients with COVID-19 has been controversial. Following our previous study, after one year, we intended to extend our sample size and results to investigate the effects of ARBs with both in-hospital outcomes and 7-month follow-up results in patients with COVID-19. Methods: Patients with a diagnosis of COVID-19 who were admitted to Sina Hospital, Tehran, Iran, from February to October 2020 participated in this follow-up cohort study. The COVID-19 diagnosis was based on a positive polymerase chain reaction test or chest computed tomography scan according to guidelines. Patients were followed for disease severity, incurring in-hospital mortality, complications, and 7-month all-cause mortality. Results: We evaluated 1413 patients with COVID-19 in this study. After excluding 124 patients, 1289 including 561(43.5%) hypertensive patients, entered the analysis. During the study, 875(67.9%) severe disease, 227(17.6%) in-hospital mortality, and 307(23.8%) 7-month all-cause mortality were observed. After adjusting for possible confounders, ARB was not associated with severity, in-hospital and 7-month all-cause mortality, and in-hospital complications except for acute kidney injury. Discontinuation of ARBs was significantly associated with higher in-hospital mortality and 7-month all-cause mortality (both P values<0.006). We observed a better 7-month outcome in those who continued their ARBs after discharge. Conclusion: The results of this study, along with the previous studies, provide reassurance that taking ARBs is not associated with the risk of mortality, complications, and poorer outcomes in hypertensive COVID-19 patients after adjustment for possible confounders.
Keywords: Angiotensin-Converting Enzyme Inhibitors; COVID-19; Hypertension; Renin-Angiotensin System; SARS-CoV-2.