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Renin-angiotensin-system inhibitors and all-cause mortality in patients with COVID-19: a systematic review and meta-analysis of observational studies.
Bavishi, Chirag; Whelton, Paul K; Mancia, Giuseppe; Corrao, Giovanni; Messerli, Franz H.
  • Bavishi C; Department of Cardiology, Lifespan Cardiovascular Institute, Warren Alpert Medical School at Brown University, Providence, Rhode Island.
  • Whelton PK; Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA.
  • Mancia G; Department of Medicine, University of Milano-Bicocca.
  • Corrao G; Division of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods.
  • Messerli FH; National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy.
J Hypertens ; 39(4): 784-794, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-1112117
Semantic information from SemMedBD (by NLM)
1. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
2. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
ABSTRACT

AIMS:

We sought to evaluate the association of angiotensin-converting-enzyme inhibitors (ACEI) or AT1 blockers (ARB) therapy with clinical outcomes in patients with coronavirus disease 2019 (COVID-19). METHODS AND

RESULTS:

Electronic databases were searched to identify published studies that reported clinical outcomes in patients with COVID-19 who were or were not taking an ACEI/ARB. We studied all-cause mortality and/or severe disease outcomes. Fully adjusted effect estimates from individual studies were pooled using a random-effects model. In total, 34 (31 cohort-based and three case-control) studies met our eligibility criteria. Due to the inherent differences between cohort and case-control studies, we did not combine results of these studies but used them to identify the consistency of their results. The 31 cohort studies provided outcome data for 87 951 patients with COVID-19, of whom 22 383/83 963 (26.7%) were on ACEI/ARB therapy. In pooled analysis, we found no association between the use of ACEI/ARB and all-cause mortality/severe disease [relative risk 0.94, 95% confidence interval (CI) 0.86-1.03, I2 = 57%, P = 0.20] or occurrence of severe disease (relative risk 0.93, 95% CI 0.74-1.17, I2 = 56%, P = 0.55). Analysis of three population-based case-control studies identified no significant association between ACEI/ARB (pooled odds ratio 1.00, 95% CI 0.81-1.23, I2 = 0, P = 0.98) and all-cause mortality/severe disease. In 13 of the 31 cohort studies as well as in three case-control studies that reported outcomes separately for ACEI and ARB, there was no differential effect for mortality/severe disease outcomes.

CONCLUSION:

In patients with COVID-19, we found no association between ACEI/ARB treatment and mortality/severe disease. ACEI/ARB should not be discontinued, unless clinically indicated.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Renin-Angiotensin System / Angiotensin-Converting Enzyme Inhibitors / Observational Studies as Topic / Angiotensin Receptor Antagonists / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: J Hypertens 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 / Observational Studies as Topic / Angiotensin Receptor Antagonists / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: J Hypertens Year: 2021 Document Type: Article