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Effects of renin-angiotensin system blockers on the risk and outcomes of severe acute respiratory syndrome coronavirus 2 infection in patients with hypertension.
Lee, Jinwoo; Jo, Seong Jin; Cho, Youngjin; Lee, Ji Hyun; Oh, Il-Young; Park, Jin Joo; Cho, Young-Seok; Choi, Dong-Ju.
  • Lee J; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
  • Jo SJ; Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea.
  • Cho Y; Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
  • Lee JH; Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
  • Oh IY; Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
  • Park JJ; Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
  • Cho YS; Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
  • Choi DJ; Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Korean J Intern Med ; 36(Suppl 1): S123-S131, 2021 03.
Article in English | MEDLINE | ID: covidwho-1369806
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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Renin-Angiotensin System / Angiotensin-Converting Enzyme Inhibitors / Angiotensin Receptor Antagonists / COVID-19 / Hypertension / Antihypertensive Agents Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Korean J Intern Med Journal subject: Internal Medicine Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Renin-Angiotensin System / Angiotensin-Converting Enzyme Inhibitors / Angiotensin Receptor Antagonists / COVID-19 / Hypertension / Antihypertensive Agents Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Korean J Intern Med Journal subject: Internal Medicine Year: 2021 Document Type: Article