tetano
Editor, Senior Moderator
J Int Med Res
. 2020 Dec;48(12):300060520979151.
doi: 10.1177/0300060520979151.
Impact of renin-angiotensin system inhibitors use on mortality in severe COVID-19 patients with hypertension: a retrospective observational study
Yanjun Zhong[SUP] 1 [/SUP], Lishu Zhao[SUP] 2 [/SUP], Guobao Wu[SUP] 1 [/SUP], Chunhong Hu[SUP] 2 [/SUP], Chenfang Wu[SUP] 1 [/SUP], Min Xu[SUP] 1 [/SUP], Haiyun Dong[SUP] 1 [/SUP], Quan Zhang[SUP] 3 [/SUP], Guyi Wang[SUP] 1 [/SUP], Bo Yu[SUP] 1 [/SUP], Jianlei Lv[SUP] 3 [/SUP], Chao Wu[SUP] 4 5 [/SUP], Siye Zhang[SUP] 1 [/SUP], Chenghui Cao[SUP] 6 [/SUP], Long Shu[SUP] 2 [/SUP], Yue Pan[SUP] 2 [/SUP], Xianling Liu[SUP] 2 [/SUP], Fang Wu[SUP] 2 [/SUP]
Affiliations
Abstract
Objective: Association of angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) use with coronavirus disease 2019 (COVID-19) remains controversial. We aimed to investigate the impact of ACEI/ARB use on all-cause mortality in severe COVID-19 patients with hypertension.
Methods: We enrolled 650 COVID-19 patients from Changsha and Wuhan city between 17 January 2020 and 8 March 2020. Demographic, clinical characteristics, and outcomes were collected. Multivariable analysis and propensity-score matching were performed to assess the impact of ACEI/ARB therapy on mortality.
Results: Among the 650 patients, 126 who had severe COVID-19 concomitant with hypertension were analyzed. The average age was 66 years and 56 (44.4%) were men. There were 37 ACEI/ARB users and 21 in-hospital deaths (mortality rate, 16.7%). Male sex (odds ratio [OR], 5.13; 95% confidence interval [CI], 1.75 to 17.8), but not ACEI/ARB use (OR, 1.09; 95%CI, 0.31 to 3.43), was an independent risk factor for mortality in severe COVID-19 patients with hypertension. After propensity-score matching, 60 severe COVID-19 patients were included and no significant correlation between use of ACEI/ARB and mortality was observed.
Conclusions: There was no significant association of ACEI/ARB use with mortality in severe COVID-19 patients with hypertension. These findings support the continuation of ACEI/ARB therapy for such patients.
Keywords: Angiotensin-converting enzyme inhibitors; angiotensin receptor blockers; coronavirus disease 2019; hypertension; mortality; renin–angiotensin system inhibitors; severe.
. 2020 Dec;48(12):300060520979151.
doi: 10.1177/0300060520979151.
Impact of renin-angiotensin system inhibitors use on mortality in severe COVID-19 patients with hypertension: a retrospective observational study
Yanjun Zhong[SUP] 1 [/SUP], Lishu Zhao[SUP] 2 [/SUP], Guobao Wu[SUP] 1 [/SUP], Chunhong Hu[SUP] 2 [/SUP], Chenfang Wu[SUP] 1 [/SUP], Min Xu[SUP] 1 [/SUP], Haiyun Dong[SUP] 1 [/SUP], Quan Zhang[SUP] 3 [/SUP], Guyi Wang[SUP] 1 [/SUP], Bo Yu[SUP] 1 [/SUP], Jianlei Lv[SUP] 3 [/SUP], Chao Wu[SUP] 4 5 [/SUP], Siye Zhang[SUP] 1 [/SUP], Chenghui Cao[SUP] 6 [/SUP], Long Shu[SUP] 2 [/SUP], Yue Pan[SUP] 2 [/SUP], Xianling Liu[SUP] 2 [/SUP], Fang Wu[SUP] 2 [/SUP]
Affiliations
- PMID: 33322988
- DOI: 10.1177/0300060520979151
Abstract
Objective: Association of angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) use with coronavirus disease 2019 (COVID-19) remains controversial. We aimed to investigate the impact of ACEI/ARB use on all-cause mortality in severe COVID-19 patients with hypertension.
Methods: We enrolled 650 COVID-19 patients from Changsha and Wuhan city between 17 January 2020 and 8 March 2020. Demographic, clinical characteristics, and outcomes were collected. Multivariable analysis and propensity-score matching were performed to assess the impact of ACEI/ARB therapy on mortality.
Results: Among the 650 patients, 126 who had severe COVID-19 concomitant with hypertension were analyzed. The average age was 66 years and 56 (44.4%) were men. There were 37 ACEI/ARB users and 21 in-hospital deaths (mortality rate, 16.7%). Male sex (odds ratio [OR], 5.13; 95% confidence interval [CI], 1.75 to 17.8), but not ACEI/ARB use (OR, 1.09; 95%CI, 0.31 to 3.43), was an independent risk factor for mortality in severe COVID-19 patients with hypertension. After propensity-score matching, 60 severe COVID-19 patients were included and no significant correlation between use of ACEI/ARB and mortality was observed.
Conclusions: There was no significant association of ACEI/ARB use with mortality in severe COVID-19 patients with hypertension. These findings support the continuation of ACEI/ARB therapy for such patients.
Keywords: Angiotensin-converting enzyme inhibitors; angiotensin receptor blockers; coronavirus disease 2019; hypertension; mortality; renin–angiotensin system inhibitors; severe.