Introduction: Corona Virus disease 2019 (COVID-19) caused by the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) has become a global pandemic. The aim of this study was to investigate the impact of being on an Angiotensin-Converting Enzyme Inhibitors (ACEI) and/or Angiotensin Receptor Blockers (ARB) on hospital admission, on the following COVID-19 outcomes: disease severity, ICU admission, and mortality. Methods: The charts of all patients consecutively diagnosed with COVID-19 from the 24th of February to the 16th of June of the year 2020 in Jaber Al-Ahmed Al-Sabah hospital in Kuwait were checked. All related patient information and clinical data was retrieved from the hospitals electronic medical record system. The primary outcome was COVID-19 disease severity defined as the need for Intensive Care Unit (ICU) admission. Secondary outcome was mortality. Results: A total of 4,019 COVID-19 patients were included, of which 325 patients (8.1%) used ACEI/ARB, users of ACEI/ARB were found to be significantly older (54.4 vs. 40.5 years). ACEI/ARB users were found to have more co-morbidities; diabetes (45.8 vs. 14.8%) and hypertension (92.9 vs. 13.0%). ACEI/ARB use was found to be significantly associated with greater risk of ICU admission in the unadjusted analysis [OR, 1.51 (95% CI: 1.04–2.19), p = 0.028]. After adjustment for age, gender, nationality, coronary artery disease, diabetes and hypertension, ICU admission was found to be inversely associated with ACEI use [OR, 0.57 (95% CI: 0.34–0.88), p = 0.01] and inversely associated with mortality [OR, 0.56 (95% CI: 0.33–0.95), p = 0.032]. Conclusion: The current evidence in the literature supports continuation of ACEI/ARB medications for patients with co-morbidities that acquire COVID-19 infection. Although, the protective effects of such medications on COVID-19 disease severity and mortality remain unclear, the findings of the present study support the use of ACEI/ARB medication.
【저자키워드】 Mortality, COVID−19, ACEi (angiotensin conversing enzyme inhibitor), ARB (angiotensin II AT1 receptor blocker), ICU–intensive care unit, 【초록키워드】 COVID-19, SARS-CoV-2, coronavirus, disease severity, hospital, intensive care unit, Gender, risk, outcome, hypertension, ICU, Coronary artery disease, global pandemic, ARB, Corona, COVID-19 infection, Patient, ICU admission, co-morbidity, Kuwait, age, Hospital admission, respiratory, medication, information, disease, Admission, protective effect, ACEi, angiotensin-converting enzyme inhibitor, Evidence, Analysis, angiotensin, COVID-19 patient, Support, Older, Primary outcome, Clinical data, COVID-19 disease severity, blocker, secondary, greater, defined, caused, significantly, diabete, checked, diagnosed with COVID-19, medications on COVID-19, retrieved, 【제목키워드】 COVID-19, ICU, ARB, angiotensin, ACE, blocker, Against,