Abstract
Background: The role of angiotensin-converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB) in the pandemic context of coronavirus disease 2019 (COVID-19) continues to be debated. Patients with hypertension, diabetes mellitus, chronic renal failure, cerebro-cardiovascular disease, or chronic obstructive pulmonary disease (COPD), who often use ACEi/ARB, may be at risk of severe COVID-19. However, there are no data available on the association of ACEi/ARB use with COVID-19 severity in this population.
Methods: This study is an observational study of patients with a positive severe acute respiratory syndrome coronavirus 2 test and inpatient treatment at a healthcare facility, using the registry information of COVIREGI-JP. Our primary outcomes were in-hospital death, ventilator support, extracorporeal membrane oxygenation support, and intensive care unit admission. Out of the 6055 patients, 1921 patients with preexisting hypertension, diabetes mellitus, chronic renal failure, cerebro-cardiovascular disease, or COPD were enrolled.
Results: Factors associated with an increased risk of the primary outcomes were aging, male sex, COPD, severe renal impairment, and diabetes mellitus. No correlations were observed with ACEi/ARB, cerebro-cardiovascular diseases, or hypertension. Associated factors in male patients were aging, renal impairment, hypertension, and diabetes. In female patients, factors associated with an increased risk were aging, ACEi/ARB, renal impairment, and diabetes, whereas hypertension was associated with a lower risk of the primary outcomes.
Conclusions: Independent factors for the primary outcomes were aging, male sex, COPD, severe renal impairment, and diabetes, but not ACEi/ARB. Based on this registry data analysis, more detailed data collection and analysis is needed with the cooperation of multiple healthcare facilities.
Keywords: Associated factors; COVID-19; Disease outcome.
【저자키워드】 COVID-19, Associated factors, Disease outcome., 【초록키워드】 Treatment, coronavirus disease, coronavirus, pandemic, Diseases, intensive care, severe COVID-19, severity, Diabetes Mellitus, risk, diabetes, outcome, hypertension, COPD, ARB, extracorporeal membrane oxygenation, healthcare, male, Patient, receptor, correlation, information, disease, Admission, patients, pulmonary disease, association, angiotensin-converting enzyme inhibitor, Analysis, Male sex, In-hospital death, Support, acute respiratory syndrome, Factor, Primary outcome, ventilator, increased risk, Primary outcomes, lower risk, Female patients, renal impairment, blocker, renal, ACEi/ARB, positive, registry data, healthcare facility, severe renal impairment, enrolled, chronic obstructive, with COVID-19, 【제목키워드】 diabetes, hypertension, Patient, Japan, registry, disease, report, renal,