The divergent protective effects of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers on clinical outcomes of coronavirus disease 2019 (COVID-19): a systematic review and meta-analysis.
Ann Palliat Med
; 11(4): 1253-1263, 2022 Apr.
Article
in English
| MEDLINE | ID: covidwho-1518874
ABSTRACT
BACKGROUND:
Some studies have speculated that patients on angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) are more susceptible to adverse outcomes of coronavirus disease 2019 (COVID-19). Here, we performed a systematic review and meta-analysis to evaluate the safety and efficacy of administering ACEIs and ARBs to patients with COVID-19.METHODS:
Studies of COVID-19 were collected from the PubMed, Embase, medRxiv and BioRxiv databases. The pooled relative risk odds ratio (OR) and 95% confidence interval (95% CI) were calculated. Subgroup analyses were conducted by medication (ACEIs and ARBs) and geographical location (China and outside China). Inter-study heterogeneity was assessed using meta-regression. Begg's test, Egger's test and funnel plots were adopted to evaluate possible publication bias.RESULTS:
Thirty studies containing 10,434 adult patients were included in our meta-analysis. The pooled result indicated that the administration of ACEIs or ARBs reduced the risk of severe/death outcomes for COVID-19 patients. Meanwhile, a significant reduction in the risk of severe/death outcomes was observed to be associated with the administration of ACEIs or ARBs among COVID-19 patients in China, but this association was weaker for studies outside China. Furthermore, ACEI therapy was found to carry a significantly lower risk of an adverse clinical outcome.DISCUSSION:
Our systematic review and meta-analysis found that neither ACEIs nor ARBs worsen the clinical outcomes of COVID-19 patients. On the contrary, we found that patients treated with ACEIs or ARBs have a reduced risk of severe/death outcomes, especially in Asia. Furthermore, ACEIs may reduce the risk of severe/death outcomes. Therefore, treatment interruption of ACEI or ARB therapy during COVID-19 infection is not recommended.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
COVID-19 Drug Treatment
/
Hypertension
Type of study:
Experimental Studies
/
Prognostic study
/
Reviews
/
Systematic review/Meta Analysis
Topics:
Long Covid
Limits:
Adult
/
Humans
Language:
English
Journal:
Ann Palliat Med
Year:
2022
Document Type:
Article
Affiliation country:
Apm-21-972
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