(1) Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) penetrates respiratory epithelium through angiotensin-converting enzyme-2 binding, raising concerns about the potentially harmful effects of renin–angiotensin system inhibitors (RASi) on Human Coronavirus Disease 2019 (COVID-19) evolution. This study aimed to provide insight into the impact of RASi on SARS-CoV-2 outcomes in patients hospitalized for COVID-19. (2) Methods: This was a retrospective analysis of hospitalized adult patients with SARS-CoV-2 infection admitted to a university hospital in France. The observation period ended at hospital discharge. (3) Results: During the study period, 943 COVID-19 patients were admitted to our institution, of whom 772 were included in this analysis. Among them, 431 (55.8%) had previously known hypertension. The median age was 68 (56–79) years. Overall, 220 (28.5%) patients were placed under mechanical ventilation and 173 (22.4%) died. According to previous exposure to RASi, we defined two groups, namely, “RASi” ( n = 282) and “RASi-free” ( n = 490). Severe pneumonia (defined as leading to death and/or requiring intubation, high-flow nasal oxygen, noninvasive ventilation, and/or oxygen flow at a rate of ≥5 L/min) and death occurred more frequently in RASi-treated patients (64% versus 53% and 29% versus 19%, respectively). However, in a propensity score-matched cohort derived from the overall population, neither death (hazard ratio (HR) 0.93 (95% confidence interval (CI) 0.57–1.50), p = 0.76) nor severe pneumonia (HR 1.03 (95%CI 0.73–1.44), p = 0.85) were associated with RASi therapy. (4) Conclusion: Our study showed no correlation between previous RASi treatment and death or severe COVID-19 pneumonia after adjustment for confounders.
【저자키워드】 COVID-19, SARS-CoV-2, Angiotensin-converting enzyme, Propensity score, angiotensin II receptor blocker, renin–angiotensin system inhibitor, 【초록키워드】 Treatment, Evolution, Severe COVID-19 pneumonia, coronavirus, therapy, Hospitalized, mechanical ventilation, Pneumonia, Infection, High-flow nasal oxygen, Noninvasive ventilation, intubation, outcome, hypertension, Cohort, Patient, death, Retrospective analysis, France, severe pneumonia, angiotensin-converting enzyme-2, inhibitor, binding, Analysis, COVID-19 patient, acute respiratory syndrome, two groups, 95%CI, 95% confidence interval, hazard ratio, median age, university hospital, study period, hospital discharge, observation period, confounders, no correlation, respiratory epithelium, oxygen flow, Effect, human coronavirus, defined, occurred, died, patients hospitalized, patients with SARS-CoV-2, penetrate, raising, 【제목키워드】 System,