Abstract
Background/aims: There are concerns that the use of renin-angiotensin system (RAS) blockers may increase the risk of being infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or progressing to a severe clinical course after infection. This this study aimed to investigate the influence of RAS blockers on the risk and severity of SARS-CoV-2 infection.
Methods: We conducted a retrospective cohort study analyzing nationwide claims data of 215,184 adults who underwent SARS-CoV-2 tests in South Korea. The SARS-CoV-2 positive rates and clinical outcomes were evaluated according to the use of RAS blockers in patients with hypertension (n = 64,243).
Results: In total, 38,919 patients with hypertension were on RAS blockers. The SARS-CoV-2 positive rates were significantly higher in the RAS blocker group than in the control group after adjustments (adjusted odds ratio [OR], 1.22; 95% confidence interval [CI], 1.10 to 1.36; p < 0.001), and matching by propensity score (adjusted OR, 1.16; 95% CI, 1.03 to 1.32; p = 0.017). Among the 1,609 SARS-CoV-2-positive patients with hypertension, the use of RAS blockers was not associated with poor outcomes, such as mortality (adjusted OR, 0.81; 95% CI, 0.56 to 1.17; p = 0.265), and a composite of admission to the intensive care unit and mortality (adjusted OR, 0.95; 95% CI, 0.73 to 1.22; p = 0.669). Analysis in the propensity scorematched population showed consistent results.
Conclusion: In this Korean nationwide claims dataset, the use of RAS blockers was associated with a higher risk to SARS-CoV-2 infection but not with higher mortality or other severe clinical courses.
Keywords: Angiotensin receptor antagonists; Angiotensin-converting enzyme inhibitor; Coronavirus infections; Hypertension.
【저자키워드】 hypertension, Coronavirus infections, angiotensin-converting enzyme inhibitor, angiotensin receptor antagonists, 【초록키워드】 SARS-CoV-2, coronavirus, Mortality, intensive care, SARS-COV-2 infection, severity, Infection, risk, hypertension, RAS, Clinical outcome, renin-angiotensin system, outcomes, Clinical course, Patient, dataset, receptor, South Korea, Admission, positive rate, Korean, angiotensin, retrospective cohort study, acute respiratory syndrome, adjusted odds ratio, control group, higher risk, 95% CI, 95% confidence interval, enzyme, blocker, blockers, SARS-CoV-2 test, courses, evaluated, conducted, adjusted, significantly higher, SARS-CoV-2-positive patient, 【제목키워드】 coronavirus, Infection, risk, outcome, hypertension, renin-angiotensin system, Patient, acute respiratory syndrome, blocker, Effect,