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10.1016/j.dsx.2020.06.047

http://scihub22266oqcxt.onion/10.1016/j.dsx.2020.06.047
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32615377!7319940!32615377
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suck abstract from ncbi


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pmid32615377      Diabetes+Metab+Syndr 2020 ; 14 (5): 983-990
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  • The use of renin angiotensin system inhibitor on mortality in patients with coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis #MMPMID32615377
  • Pranata R; Permana H; Huang I; Lim MA; Soetedjo NNM; Supriyadi R; Soeroto AY; Alkatiri AA; Firman D; Lukito AA
  • Diabetes Metab Syndr 2020[Sep]; 14 (5): 983-990 PMID32615377show ga
  • BACKGROUND: and Aims; To investigate the association between use of angiotensin-converting enzyme inhibitor (ACEI)/angiotensin-receptor blocker (ARB) and outcomes of hypertensive COVID-19 patients, a systematic review and meta-analysis were performed. METHODS: We systematically searched PubMed, EuropePMC, ProQuest, and Cochrane Central Databases using the terms "(COVID-19 OR SARS-CoV-2) AND (angiotensin converting enzyme OR angiotensin receptor blocker)". The primary and second outcomes were mortality (non-survivor) and severe COVID-19, respectively. RESULTS: Totally, 7410 patients were included from 15 studies. Pooled analysis showed that the use of ACEI/ARB was not associated with mortality (OR 0.73 [0.38, 1.40], p = 0.34; I(2): 81%) and severity (OR 1.03 [0.73, 1.45], p = 0.87; I(2): 65%). Pooled adjusted OR showed no risk/benefit associated with ACEI/ARB use in terms of mortality (OR 0.83 [0.54, 1.27], p = 0.38; I(2): 0%). Subgroup analysis showed that the use of ARB was associated with reduced mortality (OR 0.51 [0.29, 0.90], p = 0.02; I(2): 22%) but not ACEI subgroup (OR 0.68 [0.39, 1.17], p = 0.16; I(2): 0%). Meta-regression showed that the association between ACEI/ARB use and mortality in patients with COVID-19 do not varies by gender (p = 0.104). GRADE showed a very low certainty of evidence for effect of ACEI/ARB on mortality and severity. The certainty of evidence was very low for both ACEI and ARB subgroups. CONCLUSION: Administration of a renin angiotensin system (RAS) inhibitor, was not associated with increased mortality or severity of COVID-19 in patients with hypertension. Specifically, ARB and not ACEI use, was associated with lower mortality.
  • |Angiotensin Receptor Antagonists/*therapeutic use[MESH]
  • |Angiotensin-Converting Enzyme Inhibitors/*therapeutic use[MESH]
  • |Betacoronavirus/*drug effects/isolation & purification[MESH]
  • |COVID-19[MESH]
  • |Coronavirus Infections/drug therapy/epidemiology/*mortality/virology[MESH]
  • |Humans[MESH]
  • |Pandemics[MESH]
  • |Pneumonia, Viral/drug therapy/epidemiology/*mortality/virology[MESH]
  • |Prognosis[MESH]
  • |Renin-Angiotensin System/*drug effects[MESH]
  • |SARS-CoV-2[MESH]


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