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Antihypertensives and their relation to mortality by SARS-CoV-2 infection.
Singh, Sandeep; Widrich, Christine; Nap, Martijn; Schokker, Emile; Zwinderman, Aeilko H; Pinto-Sietsma, Sara-Joan.
  • Singh S; Departments of Clinical Epidemiology, Biostatistics and Bio-Informatics, Amsterdam University Medical Centre, Academic Medical Center, Amsterdam, The Netherlands.
  • Widrich C; Department of Vascular Medicine, Amsterdam University Medical Centre, Academic Medical Center, Amsterdam, The Netherlands.
  • Nap M; Department of Analytics Solutions, IQVIA Nederland, Amsterdam, The Netherlands.
  • Schokker E; Department of Analytics and Technology Solutions, IQVIA Nederland, Amsterdam, The Netherlands.
  • Zwinderman AH; IQVIA, Real World Solutions, Frankfurt, Germany.
  • Pinto-Sietsma SJ; Departments of Clinical Epidemiology, Biostatistics and Bio-Informatics, Amsterdam University Medical Centre, Academic Medical Center, Amsterdam, The Netherlands.
J Med Virol ; 93(4): 2467-2475, 2021 04.
Article in English | MEDLINE | ID: covidwho-1227756
ABSTRACT
The role of antihypertensives, especially Renin-Angiotensin-Aldosterone System inhibitors, is still debatable in COVID-19-related severity and outcome. Therefore, we search for a more global analysis of antihypertensive medication in relation to SAS-CoV-2 severity using prescription data worldwide. The association between the percentage use of different types of antihypertensive medications and mortality rates due to a SARS-CoV-2 infection during the first 3 weeks of the pandemic was analyzed using random effects linear regression models for 30 countries worldwide. Higher percentages of prescribed angiotensin receptor blockers (ARBs) (ß, 95% confidence interval [CI]; -0.02 [-0.04 to -0.0012]; p = .042) and calcium channel blockers (CCBs) (ß, 95% CI; -0.023 [-0.05 to -0.0028]; p = .0304) were associated with a lower first 3-week SARS-CoV-2-related death rate, whereas a higher percentage of prescribed angiotensin-converting enzyme inhibitors (ACEis) (ß, 95% CI; 0.03 [0.0061-0.05]; p = .0103) was associated with a higher first 3-week death rate, even when adjusted for age and metformin use. There was no association between the amount of prescribed beta-blockers (BBs) and diuretics (Diu) and the first 3-week death rate. When analyzing the combination of drugs that is used by at least 50% of antihypertensive users, within the different countries, countries with the lowest first 3-week death rates had at least an angiotensin receptor blocker as one of the most often prescribed antihypertensive medications (ARBs/CCBs [ß, 95% CI; -0.02 [-0.03 to -0.004]; p = .009], ARBs/BBs [ß, 95% CI; -0.03 [-0.05 to -0.006]; p = .01]). Finally, countries prescribing high-potency ARBs had lower first 3-week ARBs. In conclusion, ARBs and CCB seem to have a protective effect against death from SARS-CoV-2 infection.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / COVID-19 Drug Treatment / Antihypertensive Agents Type of study: Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: J Med Virol Year: 2021 Document Type: Article Affiliation country: Jmv.26775

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / COVID-19 Drug Treatment / Antihypertensive Agents Type of study: Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: J Med Virol Year: 2021 Document Type: Article Affiliation country: Jmv.26775