tetano
Editor, Senior Moderator
PLoS One
. 2022 Nov 23;17(11):e0277653.
doi: 10.1371/journal.pone.0277653. eCollection 2022.
Cardiovascular therapy use, modification, and in-hospital death in patients with COVID-19: A cohort study
Cédric Follonier[SUP] 1 2 [/SUP], Elena Tessitore[SUP] 1 [/SUP], Sandra Handgraaf[SUP] 1 [/SUP], David Carballo[SUP] 1 [/SUP], Maëlle Achard[SUP] 1 2 [/SUP], Antoinette Pechère-Bertschi[SUP] 2 3 [/SUP], François Mach[SUP] 1 2 [/SUP], François R Herrmann[SUP] 2 4 [/SUP], François R Girardin[SUP] 5 6 [/SUP]
Affiliations
Abstract
Aims: To assess the associations of exposure and modifications in exposure (i.e., discontinuation on admission, initiation during hospitalization) to eight common cardiovascular therapies with the risk of in-hospital death among inpatients with coronavirus disease 2019 (COVID-19).
Methods: In this observational study including 838 hospitalized unvaccinated adult patients with confirmed COVID-19, the use of cardiovascular therapies was assessed using logistic regression models adjusted for potential confounders.
Results: No cardiovascular therapy used before hospitalization was associated with an increased risk of in-hospital death. During hospitalization, the use of diuretics (aOR 2.59 [1.68-3.98]) was associated with an increase, and the use of agents acting on the renin-angiotensin system (aOR 0.39 [0.23-0.64]) and lipid-lowering agents (aOR 0.41 [0.24-0.68]) was associated with a reduction in the odds of in-hospital death. Exposure modifications associated with decreased survival were the discontinuation of an agent acting on the renin-angiotensin system (aOR 4.42 [2.08-9.37]), a β-blocker (aOR 5.44 [1.16-25.46]), a lipid-modifying agent (aOR 3.26 [1.42-7.50]) or an anticoagulant (aOR 5.85 [1.25-27.27]), as well as the initiation of a diuretic (aOR 5.19 [2.98-9.03]) or an antiarrhythmic (aOR 6.62 [2.07-21.15]). Exposure modification associated with improved survival was the initiation of an agent acting on the renin-angiotensin system (aOR 0.17 [0.03-0.82]).
Conclusion: In hospitalized and unvaccinated patients with COVID-19, there was no detrimental association of the prehospital use of any regular cardiovascular medication with in-hospital death, and these therapies should be continued as recommended.
. 2022 Nov 23;17(11):e0277653.
doi: 10.1371/journal.pone.0277653. eCollection 2022.
Cardiovascular therapy use, modification, and in-hospital death in patients with COVID-19: A cohort study
Cédric Follonier[SUP] 1 2 [/SUP], Elena Tessitore[SUP] 1 [/SUP], Sandra Handgraaf[SUP] 1 [/SUP], David Carballo[SUP] 1 [/SUP], Maëlle Achard[SUP] 1 2 [/SUP], Antoinette Pechère-Bertschi[SUP] 2 3 [/SUP], François Mach[SUP] 1 2 [/SUP], François R Herrmann[SUP] 2 4 [/SUP], François R Girardin[SUP] 5 6 [/SUP]
Affiliations
- PMID: 36417470
- DOI: 10.1371/journal.pone.0277653
Abstract
Aims: To assess the associations of exposure and modifications in exposure (i.e., discontinuation on admission, initiation during hospitalization) to eight common cardiovascular therapies with the risk of in-hospital death among inpatients with coronavirus disease 2019 (COVID-19).
Methods: In this observational study including 838 hospitalized unvaccinated adult patients with confirmed COVID-19, the use of cardiovascular therapies was assessed using logistic regression models adjusted for potential confounders.
Results: No cardiovascular therapy used before hospitalization was associated with an increased risk of in-hospital death. During hospitalization, the use of diuretics (aOR 2.59 [1.68-3.98]) was associated with an increase, and the use of agents acting on the renin-angiotensin system (aOR 0.39 [0.23-0.64]) and lipid-lowering agents (aOR 0.41 [0.24-0.68]) was associated with a reduction in the odds of in-hospital death. Exposure modifications associated with decreased survival were the discontinuation of an agent acting on the renin-angiotensin system (aOR 4.42 [2.08-9.37]), a β-blocker (aOR 5.44 [1.16-25.46]), a lipid-modifying agent (aOR 3.26 [1.42-7.50]) or an anticoagulant (aOR 5.85 [1.25-27.27]), as well as the initiation of a diuretic (aOR 5.19 [2.98-9.03]) or an antiarrhythmic (aOR 6.62 [2.07-21.15]). Exposure modification associated with improved survival was the initiation of an agent acting on the renin-angiotensin system (aOR 0.17 [0.03-0.82]).
Conclusion: In hospitalized and unvaccinated patients with COVID-19, there was no detrimental association of the prehospital use of any regular cardiovascular medication with in-hospital death, and these therapies should be continued as recommended.