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Association of Antihypertensive Agents with the Risk of In-Hospital Death in Patients with Covid-19.
Chouchana, Laurent; Beeker, Nathanaël; Garcelon, Nicolas; Rance, Bastien; Paris, Nicolas; Salamanca, Elisa; Polard, Elisabeth; Burgun, Anita; Treluyer, Jean-Marc; Neuraz, Antoine.
  • Chouchana L; Centre Régional de Pharmacovigilance, Département de Pharmacologie, Hôpital Cochin, AP-HP.Centre - Université de Paris, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France. laurent.chouchana@aphp.fr.
  • Beeker N; Unité de Recherche clinique, Hôpital Cochin, AP-HP.Centre - Université de Paris, Paris, France.
  • Garcelon N; Centre de Recherche des Cordeliers, INSERM UMRS_1138 Team 22, Université de Paris, Paris, France.
  • Rance B; Institut Imagine, Université de Paris, Paris, France.
  • Paris N; Centre de Recherche des Cordeliers, INSERM UMRS_1138 Team 22, Université de Paris, Paris, France.
  • Salamanca E; Département d'informatique médicale, Hôpital Européen Georges Pompidou, AP-HP.Centre - Université de Paris, Paris, France.
  • Polard E; Département Web Innovation Données (WIND), Direction des systèmes d'information, AP-HP, Paris, France.
  • Burgun A; Département Web Innovation Données (WIND), Direction des systèmes d'information, AP-HP, Paris, France.
  • Treluyer JM; Centre Régional de Pharmacovigilance, pharmacoépidémiologie et information sur le médicament, CHU Rennes, Rennes, France.
  • Neuraz A; Centre de Recherche des Cordeliers, INSERM UMRS_1138 Team 22, Université de Paris, Paris, France.
Cardiovasc Drugs Ther ; 2021 Feb 17.
Article in English | MEDLINE | ID: covidwho-1086616
ABSTRACT

PURPOSE:

The role of angiotensin receptor blockers (ARB), angiotensin-converting enzyme inhibitors (ACEi), or other antihypertensive agents in the case of Covid-19 remains controversial. We aimed to investigate the association between antihypertensive agent exposure and in-hospital mortality in patients with Covid-19.

METHODS:

We performed a retrospective multicenter cohort study on patients hospitalized between February 1 and May 15, 2020. All patients had been followed up for at least 30 days.

RESULTS:

Of the 8078 hospitalized patients for Covid-19, 3686 (45.6%) had hypertension and were included in the study. In this population, the median age was 75.4 (IQR, 21.5) years and 57.1% were male. Overall in-hospital 30-day mortality was 23.1%. The main antihypertensive pharmacological classes used were calcium channel blockers (CCB) (n=1624, 44.1%), beta-blockers (n=1389, 37.7%), ARB (n=1154, 31.3%), and ACEi (n=998, 27.1%). The risk of mortality was lower in CCB (aOR, 0.83 [0.70-0.99]) and beta-blockers (aOR, 0.80 [0.67-0.95]) users and non-significant in ARB (aOR, 0.88 [0.72-1.06]) and ACEi (aOR, 0.83 [0.68-1.02]) users, compared to non-users. These results remain consistent for patients receiving CCB, beta-blocker, or ARB as monotherapies.

CONCLUSION:

This large multicenter retrospective of Covid-19 patients with hypertension found a reduced mortality among CCB and beta-blockers users, suggesting a putative protective effect. Our findings did not show any association between the use of renin-angiotensin-aldosterone system inhibitors and the risk of in-hospital death. Although they need to be confirmed in further studies, these results support the continuation of antihypertensive agents in patients with Covid-19, in line with the current guidelines.
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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Type of study: Etiology study / Observational study / Risk factors Language: English Clinical aspect: Etiology Year: 2021

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Type of study: Etiology study / Observational study / Risk factors Language: English Clinical aspect: Etiology Year: 2021
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