tetano
Editor, Senior Moderator
PLoS One
. 2020 Dec 21;15(12):e0244349.
doi: 10.1371/journal.pone.0244349. eCollection 2020.
Positive association of angiotensin II receptor blockers, not angiotensin-converting enzyme inhibitors, with an increased vulnerability to SARS-CoV-2 infection in patients hospitalized for suspected COVID-19 pneumonia
Jean-Louis Georges[SUP] 1 [/SUP], Floriane Gilles[SUP] 1 [/SUP], H?l?ne Cochet[SUP] 1 [/SUP], Alisson Bertrand[SUP] 1 [/SUP], Marie De Tournemire[SUP] 1 [/SUP], Victorien Monguillon[SUP] 1 [/SUP], Maeva Pasqualini[SUP] 1 [/SUP], Alix Prevot[SUP] 1 [/SUP], Guillaume Roger[SUP] 1 [/SUP], Joseph Saba[SUP] 1 [/SUP], Jos?phine Soltani[SUP] 1 [/SUP], Mehrsa Koukabi-Fradelizi[SUP] 2 [/SUP], Jean-Paul Beressi[SUP] 3 [/SUP], C?cile Laureana[SUP] 4 [/SUP], Jean-Fran?ois Prost[SUP] 1 [/SUP], Bernard Livarek[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Angiotensin-converting enzyme 2 is the receptor that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) uses for entry into lung cells. Because ACE-2 may be modulated by angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs), there is concern that patients treated with ACEIs and ARBs are at higher risk of coronavirus disease 2019 (COVID-19) pneumonia.
Aim: This study sought to analyze the association of COVID-19 pneumonia with previous treatment with ACEIs and ARBs.
Materials and methods: We retrospectively reviewed 684 consecutive patients hospitalized for suspected COVID-19 pneumonia and tested by polymerase chain reaction assay. Patients were split into two groups, according to whether (group 1, n = 484) or not (group 2, n = 250) COVID-19 was confirmed. Multivariable adjusted comparisons included a propensity score analysis.
Results: The mean age was 63.6 ? 18.7 years, and 302 patients (44%) were female. Hypertension was present in 42.6% and 38.4% of patients in groups 1 and 2, respectively (P = 0.28). Treatment with ARBs was more frequent in group 1 than group 2 (20.7% vs. 12.0%, respectively; odds ratio [OR] 1.92, 95% confidence interval [CI] 1.23-2.98; P = 0.004). No difference was found for treatment with ACEIs (12.7% vs. 15.7%, respectively; OR 0.81, 95% CI 0.52-1.26; P = 0.35). Propensity score-matched multivariable logistic regression confirmed a significant association between COVID-19 and previous treatment with ARBs (adjusted OR 2.36, 95% CI 1.38-4.04; P = 0.002). Significant interaction between ARBs and ACEIs for the risk of COVID-19 was observed in patients aged > 60 years, women, and hypertensive patients.
Conclusions: This study suggests that ACEIs and ARBs are not similarly associated with COVID-19. In this retrospective series, patients with COVID-19 pneumonia more frequently had previous treatment with ARBs compared with patients without COVID-19.
. 2020 Dec 21;15(12):e0244349.
doi: 10.1371/journal.pone.0244349. eCollection 2020.
Positive association of angiotensin II receptor blockers, not angiotensin-converting enzyme inhibitors, with an increased vulnerability to SARS-CoV-2 infection in patients hospitalized for suspected COVID-19 pneumonia
Jean-Louis Georges[SUP] 1 [/SUP], Floriane Gilles[SUP] 1 [/SUP], H?l?ne Cochet[SUP] 1 [/SUP], Alisson Bertrand[SUP] 1 [/SUP], Marie De Tournemire[SUP] 1 [/SUP], Victorien Monguillon[SUP] 1 [/SUP], Maeva Pasqualini[SUP] 1 [/SUP], Alix Prevot[SUP] 1 [/SUP], Guillaume Roger[SUP] 1 [/SUP], Joseph Saba[SUP] 1 [/SUP], Jos?phine Soltani[SUP] 1 [/SUP], Mehrsa Koukabi-Fradelizi[SUP] 2 [/SUP], Jean-Paul Beressi[SUP] 3 [/SUP], C?cile Laureana[SUP] 4 [/SUP], Jean-Fran?ois Prost[SUP] 1 [/SUP], Bernard Livarek[SUP] 1 [/SUP]
Affiliations
- PMID: 33347477
- DOI: 10.1371/journal.pone.0244349
Abstract
Background: Angiotensin-converting enzyme 2 is the receptor that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) uses for entry into lung cells. Because ACE-2 may be modulated by angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs), there is concern that patients treated with ACEIs and ARBs are at higher risk of coronavirus disease 2019 (COVID-19) pneumonia.
Aim: This study sought to analyze the association of COVID-19 pneumonia with previous treatment with ACEIs and ARBs.
Materials and methods: We retrospectively reviewed 684 consecutive patients hospitalized for suspected COVID-19 pneumonia and tested by polymerase chain reaction assay. Patients were split into two groups, according to whether (group 1, n = 484) or not (group 2, n = 250) COVID-19 was confirmed. Multivariable adjusted comparisons included a propensity score analysis.
Results: The mean age was 63.6 ? 18.7 years, and 302 patients (44%) were female. Hypertension was present in 42.6% and 38.4% of patients in groups 1 and 2, respectively (P = 0.28). Treatment with ARBs was more frequent in group 1 than group 2 (20.7% vs. 12.0%, respectively; odds ratio [OR] 1.92, 95% confidence interval [CI] 1.23-2.98; P = 0.004). No difference was found for treatment with ACEIs (12.7% vs. 15.7%, respectively; OR 0.81, 95% CI 0.52-1.26; P = 0.35). Propensity score-matched multivariable logistic regression confirmed a significant association between COVID-19 and previous treatment with ARBs (adjusted OR 2.36, 95% CI 1.38-4.04; P = 0.002). Significant interaction between ARBs and ACEIs for the risk of COVID-19 was observed in patients aged > 60 years, women, and hypertensive patients.
Conclusions: This study suggests that ACEIs and ARBs are not similarly associated with COVID-19. In this retrospective series, patients with COVID-19 pneumonia more frequently had previous treatment with ARBs compared with patients without COVID-19.