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10.1161/CIRCRESAHA.120.317134

http://scihub22266oqcxt.onion/10.1161/CIRCRESAHA.120.317134
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32302265!7265882!32302265
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suck abstract from ncbi


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pmid32302265      Circ+Res 2020 ; 126 (12): 1671-1681
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  • Association of Inpatient Use of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers With Mortality Among Patients With Hypertension Hospitalized With COVID-19 #MMPMID32302265
  • Zhang P; Zhu L; Cai J; Lei F; Qin JJ; Xie J; Liu YM; Zhao YC; Huang X; Lin L; Xia M; Chen MM; Cheng X; Zhang X; Guo D; Peng Y; Ji YX; Chen J; She ZG; Wang Y; Xu Q; Tan R; Wang H; Lin J; Luo P; Fu S; Cai H; Ye P; Xiao B; Mao W; Liu L; Yan Y; Liu M; Chen M; Zhang XJ; Wang X; Touyz RM; Xia J; Zhang BH; Huang X; Yuan Y; Loomba R; Liu PP; Li H
  • Circ Res 2020[Jun]; 126 (12): 1671-1681 PMID32302265show ga
  • RATIONALE: Use of ACEIs (angiotensin-converting enzyme inhibitors) and ARBs (angiotensin II receptor blockers) is a major concern for clinicians treating coronavirus disease 2019 (COVID-19) in patients with hypertension. OBJECTIVE: To determine the association between in-hospital use of ACEI/ARB and all-cause mortality in patients with hypertension and hospitalized due to COVID-19. METHODS AND RESULTS: This retrospective, multi-center study included 1128 adult patients with hypertension diagnosed with COVID-19, including 188 taking ACEI/ARB (ACEI/ARB group; median age 64 [interquartile range, 55-68] years; 53.2% men) and 940 without using ACEI/ARB (non-ACEI/ARB group; median age 64 [interquartile range 57-69]; 53.5% men), who were admitted to 9 hospitals in Hubei Province, China from December 31, 2019 to February 20, 2020. In mixed-effect Cox model treating site as a random effect, after adjusting for age, gender, comorbidities, and in-hospital medications, the detected risk for all-cause mortality was lower in the ACEI/ARB group versus the non-ACEI/ARB group (adjusted hazard ratio, 0.42 [95% CI, 0.19-0.92]; P=0.03). In a propensity score-matched analysis followed by adjusting imbalanced variables in mixed-effect Cox model, the results consistently demonstrated lower risk of COVID-19 mortality in patients who received ACEI/ARB versus those who did not receive ACEI/ARB (adjusted hazard ratio, 0.37 [95% CI, 0.15-0.89]; P=0.03). Further subgroup propensity score-matched analysis indicated that, compared with use of other antihypertensive drugs, ACEI/ARB was also associated with decreased mortality (adjusted hazard ratio, 0.30 [95% CI, 0.12-0.70]; P=0.01) in patients with COVID-19 and coexisting hypertension. CONCLUSIONS: Among hospitalized patients with COVID-19 and coexisting hypertension, inpatient use of ACEI/ARB was associated with lower risk of all-cause mortality compared with ACEI/ARB nonusers. While study interpretation needs to consider the potential for residual confounders, it is unlikely that in-hospital use of ACEI/ARB was associated with an increased mortality risk.
  • |*Hospital Mortality[MESH]
  • |Aged[MESH]
  • |Angiotensin Receptor Antagonists/*adverse effects/therapeutic use[MESH]
  • |Angiotensin-Converting Enzyme Inhibitors/*adverse effects/therapeutic use[MESH]
  • |COVID-19[MESH]
  • |Coronavirus Infections/complications/*epidemiology[MESH]
  • |Female[MESH]
  • |Humans[MESH]
  • |Hypertension/complications/drug therapy/*epidemiology[MESH]
  • |Inpatients/statistics & numerical data[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Pandemics[MESH]


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