tetano
Editor, Senior Moderator
World J Clin Cases
. 2021 Jan 6;9(1):47-60.
doi: 10.12998/wjcc.v9.i1.47.
Angiotensin converting enzymes inhibitors or angiotensin receptor blockers should be continued in COVID-19 patients with hypertension
Ci Tian[SUP] 1 [/SUP], Nan Li[SUP] 2 [/SUP], Yi Bai[SUP] 1 [/SUP], Han Xiao[SUP] 3 [/SUP], Shu Li[SUP] 1 [/SUP], Qing-Gang Ge[SUP] 4 [/SUP], Ning Shen[SUP] 5 [/SUP], Qing-Bian Ma[SUP] 6 [/SUP]
Affiliations
Abstract
Background: Recent studies have revealed that sustained ingestion of angiotensin converting enzymes inhibitors or angiotensin receptor blockers (ACEIs/ARBs) had no harmful effects on coronavirus disease 2019 (COVID-19) patients complicated with hypertension.
Aim: To investigate the impact on COVID-19 patients complicated with hypertension who discontinued using ACEIs/ARBs.
Methods: All COVID-19 patients complicated with hypertension admitted to our isolated unit were consecutively recruited in this study. Some patients switched from ACEIs/ARBs to calcium channel blocker (CCBs) after admission, while others continued using non-ACEIs/ARBs. We compared characteristics and clinical outcomes between these two groups of patients.
Results: A total of 53 patients were enrolled, 27 patients switched from ACEIs/ARBs to CCBs while 26 patients continued with non-ACEIs/ARBs. After controlling potential confounding factors using the Cox proportional hazards model, hospital stay was longer in patients who discontinued ACEIs/ARBs, with a hazard ratio of 0.424 (95% confidence interval: 0.187-0.962; P = 0.040), upon discharge than patients using other anti-hypertensive drugs. A sub-group analysis showed that the effect of discontinuing use of ACEIs/ARBs was stronger in moderate cases [hazard ratio = 0.224 (95% confidence interval: 0.005-0.998; P = 0.0497)].
Conclusion: Patients in the discontinued ACEIs/ARBs group had longer hospital stays. Our findings suggest that COVID-19 patients complicated with hypertension should continue to use ACEIs/ARBs.
Keywords: Angiotensin converting enzymes inhibitors; Angiotensin receptor blockers; Angiotensin-converting enzyme-2; COVID-19; Hypertension; Prognosis.
. 2021 Jan 6;9(1):47-60.
doi: 10.12998/wjcc.v9.i1.47.
Angiotensin converting enzymes inhibitors or angiotensin receptor blockers should be continued in COVID-19 patients with hypertension
Ci Tian[SUP] 1 [/SUP], Nan Li[SUP] 2 [/SUP], Yi Bai[SUP] 1 [/SUP], Han Xiao[SUP] 3 [/SUP], Shu Li[SUP] 1 [/SUP], Qing-Gang Ge[SUP] 4 [/SUP], Ning Shen[SUP] 5 [/SUP], Qing-Bian Ma[SUP] 6 [/SUP]
Affiliations
- PMID: 33511171
- PMCID: PMC7809663
- DOI: 10.12998/wjcc.v9.i1.47
Abstract
Background: Recent studies have revealed that sustained ingestion of angiotensin converting enzymes inhibitors or angiotensin receptor blockers (ACEIs/ARBs) had no harmful effects on coronavirus disease 2019 (COVID-19) patients complicated with hypertension.
Aim: To investigate the impact on COVID-19 patients complicated with hypertension who discontinued using ACEIs/ARBs.
Methods: All COVID-19 patients complicated with hypertension admitted to our isolated unit were consecutively recruited in this study. Some patients switched from ACEIs/ARBs to calcium channel blocker (CCBs) after admission, while others continued using non-ACEIs/ARBs. We compared characteristics and clinical outcomes between these two groups of patients.
Results: A total of 53 patients were enrolled, 27 patients switched from ACEIs/ARBs to CCBs while 26 patients continued with non-ACEIs/ARBs. After controlling potential confounding factors using the Cox proportional hazards model, hospital stay was longer in patients who discontinued ACEIs/ARBs, with a hazard ratio of 0.424 (95% confidence interval: 0.187-0.962; P = 0.040), upon discharge than patients using other anti-hypertensive drugs. A sub-group analysis showed that the effect of discontinuing use of ACEIs/ARBs was stronger in moderate cases [hazard ratio = 0.224 (95% confidence interval: 0.005-0.998; P = 0.0497)].
Conclusion: Patients in the discontinued ACEIs/ARBs group had longer hospital stays. Our findings suggest that COVID-19 patients complicated with hypertension should continue to use ACEIs/ARBs.
Keywords: Angiotensin converting enzymes inhibitors; Angiotensin receptor blockers; Angiotensin-converting enzyme-2; COVID-19; Hypertension; Prognosis.