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10.1016/j.vph.2020.106805

http://scihub22266oqcxt.onion/10.1016/j.vph.2020.106805
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suck abstract from ncbi


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pmid32992048      Vascul+Pharmacol 2020 ; 135 (ä): 106805
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  • RAAS inhibitors are not associated with mortality in COVID-19 patients: Findings from an observational multicenter study in Italy and a meta-analysis of 19 studies #MMPMID32992048
  • ä
  • Vascul Pharmacol 2020[Dec]; 135 (ä): 106805 PMID32992048show ga
  • OBJECTIVE: The hypothesis that been set forward that use of Renin Angiotensin Aldosterone System (RAAS) inhibitors is associated with COVID-19 severity. We set-up a multicenter Italian collaboration (CORIST Project, ClinicalTrials.gov ID: NCT04318418) to retrospectively investigate the relationship between RAAS inhibitors and COVID-19 in-hospital mortality. We also carried out an updated meta-analysis on the relevant studies. METHODS: We analyzed 4069 unselected patients with laboratory-confirmed SARS-CoV-2 infection and hospitalized in 34 clinical centers in Italy from February 19, 2020 to May 23, 2020. The primary end-point in a time-to event analysis was in-hospital death, comparing patients who received angiotensin-converting-enzyme inhibitors (ACEI) or angiotensin-receptor blockers (ARB) with patients who did not. Articles for the meta-analysis were retrieved until July 13th, 2020 by searching in web-based libraries, and data were combined using the general variance-based method. RESULTS: Out of 4069 COVID-19 patients, 13.5% and 13.3% received ACE-I or ARB, respectively. Use of neither ACE-I nor ARB was associated with mortality (multivariable hazard ratio (HR) adjusted also for COVID-19 treatments: 0.96, 95% confidence interval 0.77-1.20 and HR = 0.89, 0.67-1.19 for ACE-I and ARB, respectively). Findings were similar restricting the analysis to hypertensive (N = 2057) patients (HR = 1.00, 0.78-1.26 and HR = 0.88, 0.65-1.20) or when ACE-I or ARB were considered as a single group. Results from the meta-analysis (19 studies, 29,057 COVID-19 adult patients, 9700 with hypertension) confirmed the absence of association. CONCLUSIONS: In this observational study and meta-analysis of the literature, ACE-I or ARB use was not associated with severity or in-hospital mortality in COVID-19 patients.
  • |*Hospital Mortality[MESH]
  • |Aged[MESH]
  • |Aged, 80 and over[MESH]
  • |Angiotensin Receptor Antagonists/adverse effects/*therapeutic use[MESH]
  • |Angiotensin-Converting Enzyme Inhibitors/adverse effects/*therapeutic use[MESH]
  • |Antihypertensive Agents/adverse effects/*therapeutic use[MESH]
  • |COVID-19/diagnosis/*mortality/therapy[MESH]
  • |Female[MESH]
  • |Hospitalization[MESH]
  • |Humans[MESH]
  • |Hypertension/*drug therapy/epidemiology/physiopathology[MESH]
  • |Incidence[MESH]
  • |Italy/epidemiology[MESH]
  • |Male[MESH]
  • |Meta-Analysis as Topic[MESH]
  • |Middle Aged[MESH]
  • |Renin-Angiotensin System/*drug effects[MESH]
  • |Risk Assessment[MESH]
  • |Risk Factors[MESH]


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