Antihypertensive medication and outcome in patients with COVID-19 compared to non-COVID respiratory infections
European Heart Journal
; 42(SUPPL 1):2395, 2021.
Article
in English
| EMBASE | ID: covidwho-1553937
ABSTRACT
Background:
Recent reports suggested no adverse effects of antihypertensive medication including inhibitors of the renin-angiotensin system on outcome of patients with coronavirus disease 19 (COVID-19). However, most of these studies lack adequate control groups, and regional and socio-economic differences may additionally affect clinical course and outcome of COVID-19.Methods:
In the prospective observational cohort COrona VIrus surviVAl (COVIVA) study at our university hospital, we consecutively enrolled patients presenting to the emergency department with symptoms suggestive of COVID-19 between March and June 2020. Patients tested positive for COVID-19 (cases) were compared with patients tested negative, who had a respiratory infection (respiratory control). Primary outcome measure was the composite of ICU admission, 3'-day mortality or rehospitalization for respiratory symptoms.Results:
The final analysis consisted of 191 patients with COVID-19 and 323 respiratory controls. Sixty cases (31.4%) and 87 (26.9%) respiratory control patients were on ACE inhibitors (ACE-I) or angiotensin II receptor blockers (ARB). In unadjusted models the hazard ratio [95% CI] for the composite outcome for patients on ACE-I/ARBs was 2.36 [1.34;4.16], p=0.003 and 2.05 [1.03;4.09], p=0.04 among patients with COVID-19 and respiratory controls, respectively. The corresponding multivariable adjusted HRs were 1.32 [0.68;2.55], p=0.41 and 1.20 [0.58;2.48], p=0.62. Furthermore, we did not observe an increased risk for the outcome when assessing ACE-Is and ARBs separately or other antihypertensive agents, both in COVID-19 patients and respiratory controls (Table).Conclusions:
In a Swiss cohort of patients with COVID-19 or non-COVID respiratory controls treatment with ACE-I/ARBs or other antihypertensive medication was not associated with adverse events after accounting for comorbidities and risk factors.
angiotensin, receptor, antagonist; dipeptidyl, carboxypeptidase; dipeptidyl, carboxypeptidase, inhibitor; endogenous, compound; adult; cohort, analysis; comorbidity; conference,; controlled, study; coronavirus, disease, 2019; emergency, ward; female; hospital, readmission; human; major, clinical, study; male; mortality; physical, disease, by, body, function; prospective, study; respiration, control; risk, assessment; risk, factor; Swiss; university, hospital; virus, survival
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Prognostic study
Language:
English
Journal:
European Heart Journal
Year:
2021
Document Type:
Article
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