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10.4178/epih.e2021004

http://scihub22266oqcxt.onion/10.4178/epih.e2021004
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33445824!7973148!33445824
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suck abstract from ncbi


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pmid33445824      Epidemiol+Health 2021 ; 43 (ä): e2021004
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  • Clinical outcomes of COVID-19 following the use of angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers among patients with hypertension in Korea: a nationwide study #MMPMID33445824
  • Kim JH; Baek YH; Lee H; Choe YJ; Shin HJ; Shin JY
  • Epidemiol Health 2021[]; 43 (ä): e2021004 PMID33445824show ga
  • OBJECTIVES: Recent evidence has shown no harm associated with the use of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin-receptor blockers (ARBs) in patients with coronavirus disease 2019 (COVID-19). We sought to further clarify the possible association between ACEI/ARB use and the risk of poor clinical outcomes of COVID-19. METHODS: From the completely enumerated COVID-19 cohort in Korea, we identified 1,290 patients with hypertension, of whom 682 had and 603 did not have records of ACEI/ARB use during the 30-day period before their COVID-19 diagnosis. Our primary endpoint comprised clinical outcomes, including all-cause mortality, use of mechanical ventilation, intensive care unit admission, and sepsis. We used inverse probability of treatment weighting (IPTW) to mitigate selection bias, and a Poisson regression model to estimate the relative risks (RRs) and 95% confidence intervals (CIs) for comparing outcomes between ACEI/ARB users and non-users. RESULTS: Compared to non-use, ACEI/ARB use was associated with lower clinical outcomes (IPTW-adjusted RR, 0.60; 95% CI, 0.42 to 0.85; p=0.005). For individual outcomes, ACEI/ARB use was not associated with all-cause mortality (IPTW-adjusted RR, 0.62; 95% CI, 0.35 to 1.09; p=0.097) or respiratory events (IPTW-adjusted RR, 0.99; 95% CI, 0.84 to 1.17; p=0.904). Subgroup analysis showed a trend toward a protective role of ACEIs and ARBs against overall outcomes in men (IPTW-adjusted RR, 0.84; 95% CI, 0.69 to 1.03; pinteraction=0.008) and patients with pre-existing respiratory disease (IPTW-adjusted RR, 0.74; 95% CI, 0.60 to 0.92; pinteraction=0.002). CONCLUSIONS: We present clinical evidence to support continuing ACE/ARB use in COVID-19 patients with hypertension based on the completely enumerated Korean cohort.
  • |*COVID-19 Drug Treatment[MESH]
  • |Adult[MESH]
  • |Aged[MESH]
  • |Aged, 80 and over[MESH]
  • |Angiotensin Receptor Antagonists/*therapeutic use[MESH]
  • |Angiotensin-Converting Enzyme Inhibitors/*therapeutic use[MESH]
  • |COVID-19/epidemiology[MESH]
  • |Cohort Studies[MESH]
  • |Female[MESH]
  • |Humans[MESH]
  • |Hypertension/*drug therapy/epidemiology[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Republic of Korea/epidemiology[MESH]


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