tetano
Editor, Senior Moderator
J Clin Med
. 2020 Oct 28;9(11):E3472.
doi: 10.3390/jcm9113472.
Outcomes of COVID-19 Hospitalized Patients Previously Treated with Renin-Angiotensin System Inhibitors
Elena-Mihaela Cordeanu[SUP] 1 [/SUP], Lucas Jambert[SUP] 2 [/SUP], Francois Severac[SUP] 3 [/SUP], H?l?ne Lambach[SUP] 1 [/SUP], Jonathan Tousch[SUP] 1 [/SUP], Marie Heitz[SUP] 1 [/SUP], Corina Mirea[SUP] 1 [/SUP], Amer Hamad?[SUP] 2 [/SUP], Wa?l Younes[SUP] 4 [/SUP], Anne-Sophie Frantz[SUP] 1 [/SUP], Hamid Merdji[SUP] 5 [/SUP], Val?rie Schini-Kerth[SUP] 6 [/SUP], Pascal Bilbault[SUP] 7 [/SUP], Ferhat Meziani[SUP] 5 [/SUP], Patrick Ohlmann[SUP] 8 [/SUP], Emmanuel Andres[SUP] 9 [/SUP], Dominique Stephan[SUP] 1 [/SUP]
Affiliations
Abstract
(1) Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) penetrates respiratory epithelium through angiotensin-converting enzyme-2 binding, raising concerns about the potentially harmful effects of renin-angiotensin system inhibitors (RASi) on Human Coronavirus Disease 2019 (COVID-19) evolution. This study aimed to provide insight into the impact of RASi on SARS-CoV-2 outcomes in patients hospitalized for COVID-19. (2) Methods: This was a retrospective analysis of hospitalized adult patients with SARS-CoV-2 infection admitted to a university hospital in France. The observation period ended at hospital discharge. (3) Results: During the study period, 943 COVID-19 patients were admitted to our institution, of whom 772 were included in this analysis. Among them, 431 (55.8%) had previously known hypertension. The median age was 68 (56-79) years. Overall, 220 (28.5%) patients were placed under mechanical ventilation and 173 (22.4%) died. According to previous exposure to RASi, we defined two groups, namely, "RASi" (n = 282) and "RASi-free" (n = 490). Severe pneumonia (defined as leading to death and/or requiring intubation, high-flow nasal oxygen, noninvasive ventilation, and/or oxygen flow at a rate of ≥5 L/min) and death occurred more frequently in RASi-treated patients (64% versus 53% and 29% versus 19%, respectively). However, in a propensity score-matched cohort derived from the overall population, neither death (hazard ratio (HR) 0.93 (95% confidence interval (CI) 0.57-1.50), p = 0.76) nor severe pneumonia (HR 1.03 (95%CI 0.73-1.44), p = 0.85) were associated with RASi therapy. (4) Conclusion: Our study showed no correlation between previous RASi treatment and death or severe COVID-19 pneumonia after adjustment for confounders.
Keywords: COVID-19; SARS-CoV-2; angiotensin II receptor blocker; angiotensin-converting enzyme; propensity score; renin–angiotensin system inhibitor.
. 2020 Oct 28;9(11):E3472.
doi: 10.3390/jcm9113472.
Outcomes of COVID-19 Hospitalized Patients Previously Treated with Renin-Angiotensin System Inhibitors
Elena-Mihaela Cordeanu[SUP] 1 [/SUP], Lucas Jambert[SUP] 2 [/SUP], Francois Severac[SUP] 3 [/SUP], H?l?ne Lambach[SUP] 1 [/SUP], Jonathan Tousch[SUP] 1 [/SUP], Marie Heitz[SUP] 1 [/SUP], Corina Mirea[SUP] 1 [/SUP], Amer Hamad?[SUP] 2 [/SUP], Wa?l Younes[SUP] 4 [/SUP], Anne-Sophie Frantz[SUP] 1 [/SUP], Hamid Merdji[SUP] 5 [/SUP], Val?rie Schini-Kerth[SUP] 6 [/SUP], Pascal Bilbault[SUP] 7 [/SUP], Ferhat Meziani[SUP] 5 [/SUP], Patrick Ohlmann[SUP] 8 [/SUP], Emmanuel Andres[SUP] 9 [/SUP], Dominique Stephan[SUP] 1 [/SUP]
Affiliations
- PMID: 33126565
- DOI: 10.3390/jcm9113472
Abstract
(1) Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) penetrates respiratory epithelium through angiotensin-converting enzyme-2 binding, raising concerns about the potentially harmful effects of renin-angiotensin system inhibitors (RASi) on Human Coronavirus Disease 2019 (COVID-19) evolution. This study aimed to provide insight into the impact of RASi on SARS-CoV-2 outcomes in patients hospitalized for COVID-19. (2) Methods: This was a retrospective analysis of hospitalized adult patients with SARS-CoV-2 infection admitted to a university hospital in France. The observation period ended at hospital discharge. (3) Results: During the study period, 943 COVID-19 patients were admitted to our institution, of whom 772 were included in this analysis. Among them, 431 (55.8%) had previously known hypertension. The median age was 68 (56-79) years. Overall, 220 (28.5%) patients were placed under mechanical ventilation and 173 (22.4%) died. According to previous exposure to RASi, we defined two groups, namely, "RASi" (n = 282) and "RASi-free" (n = 490). Severe pneumonia (defined as leading to death and/or requiring intubation, high-flow nasal oxygen, noninvasive ventilation, and/or oxygen flow at a rate of ≥5 L/min) and death occurred more frequently in RASi-treated patients (64% versus 53% and 29% versus 19%, respectively). However, in a propensity score-matched cohort derived from the overall population, neither death (hazard ratio (HR) 0.93 (95% confidence interval (CI) 0.57-1.50), p = 0.76) nor severe pneumonia (HR 1.03 (95%CI 0.73-1.44), p = 0.85) were associated with RASi therapy. (4) Conclusion: Our study showed no correlation between previous RASi treatment and death or severe COVID-19 pneumonia after adjustment for confounders.
Keywords: COVID-19; SARS-CoV-2; angiotensin II receptor blocker; angiotensin-converting enzyme; propensity score; renin–angiotensin system inhibitor.