Abstract
Objective: Association of angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) use with coronavirus disease 2019 (COVID-19) remains controversial. We aimed to investigate the impact of ACEI/ARB use on all-cause mortality in severe COVID-19 patients with hypertension.
Methods: We enrolled 650 COVID-19 patients from Changsha and Wuhan city between 17 January 2020 and 8 March 2020. Demographic, clinical characteristics, and outcomes were collected. Multivariable analysis and propensity-score matching were performed to assess the impact of ACEI/ARB therapy on mortality.
Results: Among the 650 patients, 126 who had severe COVID-19 concomitant with hypertension were analyzed. The average age was 66 years and 56 (44.4%) were men. There were 37 ACEI/ARB users and 21 in-hospital deaths (mortality rate, 16.7%). Male sex (odds ratio [OR], 5.13; 95% confidence interval [CI], 1.75 to 17.8), but not ACEI/ARB use (OR, 1.09; 95%CI, 0.31 to 3.43), was an independent risk factor for mortality in severe COVID-19 patients with hypertension. After propensity-score matching, 60 severe COVID-19 patients were included and no significant correlation between use of ACEI/ARB and mortality was observed.
Conclusions: There was no significant association of ACEI/ARB use with mortality in severe COVID-19 patients with hypertension. These findings support the continuation of ACEI/ARB therapy for such patients.
Keywords: Angiotensin-converting enzyme inhibitors; angiotensin receptor blockers; coronavirus disease 2019; hypertension; mortality; renin–angiotensin system inhibitors; severe.
【저자키워드】 Coronavirus disease 2019, Mortality, severe, hypertension, Angiotensin receptor blockers, angiotensin-converting enzyme inhibitors, renin–angiotensin system inhibitors, 【초록키워드】 COVID-19, coronavirus disease, therapy, severe COVID-19, Clinical characteristics, Sex, outcome, ARB, Wuhan, age, receptor, mortality rate, correlation, demographic, patients, association, ACEi, angiotensin receptor blocker, angiotensin-converting enzyme inhibitor, Analysis, Odds ratio, COVID-19 patient, In-hospital death, Support, 95%CI, 95% confidence interval, enzyme, average, all-cause mortality, independent risk factor, men, enrolled, analyzed, performed, collected, severe COVID-19 patient, 【제목키워드】 renin-angiotensin system, Impact, inhibitor, retrospective, severe COVID-19 patient,