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10.1111/bcp.15331

http://scihub22266oqcxt.onion/10.1111/bcp.15331
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35322889!9111446!35322889
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suck abstract from ncbi


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pmid35322889      Br+J+Clin+Pharmacol 2022 ; 88 (8): 3577-3599
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  • Cardiovascular drugs and COVID-19 clinical outcomes: a systematic review and meta-analysis of randomized controlled trials #MMPMID35322889
  • Asiimwe IG; Pushpakom SP; Turner RM; Kolamunnage-Dona R; Jorgensen AL; Pirmohamed M
  • Br J Clin Pharmacol 2022[Aug]; 88 (8): 3577-3599 PMID35322889show ga
  • AIMS: To update our previously reported systematic review and meta-analysis of observational studies on cardiovascular drug exposure and COVID-19 clinical outcomes by focusing on newly published randomized controlled trials (RCTs). METHODS: More than 500 databases were searched between 1 November 2020 and 2 October 2021 to identify RCTs that were published after our baseline review. One reviewer extracted data with other reviewers verifying the extracted data for accuracy and completeness. RESULTS: After screening 22 414 records, we included 24 and 21 RCTs in the qualitative and quantitative syntheses, respectively. The most investigated drug classes were angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blocker (ARBs) and anticoagulants, investigated by 10 and 11 studies respectively. In meta-analyses, ACEI/ARBs did not affect hospitalization length (mean difference -0.42, 95% confidence interval [CI] -1.83; 0.98 d, n = 1183), COVID-19 severity (risk ratio/RR 0.90, 95% CI 0.71; 1.15, n = 1661) or mortality (risk ratio [RR] 0.92, 95% CI 0.58; 1.47, n = 1646). Therapeutic anticoagulation also had no effect (hospitalization length mean difference -0.29, 95% CI -1.13 to 0.56 d, n = 1449; severity RR 0.86, 95% CI 0.70; 1.04, n = 2696; and, mortality RR 0.93, 95% CI 0.77; 1.13, n = 5689). Other investigated drug classes were antiplatelets (aspirin, 2 trials), antithrombotics (sulodexide, 1 trial), calcium channel blockers (amlodipine, 1 trial) and lipid-modifying drugs (atorvastatin, 1 trial). CONCLUSION: Moderate- to high-certainty RCT evidence suggests that cardiovascular drugs such as ACEIs/ARBs are not associated with poor COVID-19 outcomes, and should therefore not be discontinued. These cardiovascular drugs should also not be initiated to treat or prevent COVID-19 unless they are needed for an underlying currently approved therapeutic indication.
  • |*COVID-19 Drug Treatment[MESH]
  • |*Cardiovascular Agents/adverse effects[MESH]
  • |Angiotensin-Converting Enzyme Inhibitors/adverse effects[MESH]
  • |Antihypertensive Agents/therapeutic use[MESH]
  • |Humans[MESH]
  • |Observational Studies as Topic[MESH]


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