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Calcium channel blockers improve prognosis of patients with coronavirus disease 2019 and hypertension.
Peng, Chi; Wang, Hao; Guo, Yu-Feng; Qi, Ge-Yao; Zhang, Chen-Xu; Chen, Ting; He, Jia; Jin, Zhi-Chao.
  • Peng C; Department of Health Statistics, Naval Medical University, Shanghai 200433, China.
  • Wang H; Department of Colorectal Surgery, Changhai Hospital, Naval Medical University, Shanghai 200433, China.
  • Guo YF; Department of Medical Administration, Changzheng Hospital, Naval Medical University, Shanghai 200003, China.
  • Qi GY; Department of Health Statistics, Naval Medical University, Shanghai 200433, China.
  • Zhang CX; Department of Health Statistics, Naval Medical University, Shanghai 200433, China.
  • Chen T; Department of Cardiology, Changzheng Hospital, Naval Medical University, Shanghai 200003, China.
  • He J; Department of Health Statistics, Naval Medical University, Shanghai 200433, China.
  • Jin ZC; Department of Health Statistics, Naval Medical University, Shanghai 200433, China.
Chin Med J (Engl) ; 134(13): 1602-1609, 2021 Jun 16.
Article in English | MEDLINE | ID: covidwho-1769421
Semantic information from SemMedBD (by NLM)
1. Hypertensive disease PROCESS_OF Patients
Subject
Hypertensive disease
Predicate
PROCESS_OF
Object
Patients
2. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
3. Hypertensive disease PREDISPOSES COVID-19
Subject
Hypertensive disease
Predicate
PREDISPOSES
Object
COVID-19
4. Laboratory Procedures USES TNFRSF11A protei
Subject
Laboratory Procedures
Predicate
USES
Object
TNFRSF11A protei
5. COVID-19 PROCESS_OF hospitalized patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
hospitalized patients
6. Adrenergic beta-Antagonists TREATS Hypertensive disease
Subject
Adrenergic beta-Antagonists
Predicate
TREATS
Object
Hypertensive disease
7. Adrenergic beta-Antagonists TREATS COVID-19
Subject
Adrenergic beta-Antagonists
Predicate
TREATS
Object
COVID-19
8. Adrenergic beta-Antagonists TREATS Patients
Subject
Adrenergic beta-Antagonists
Predicate
TREATS
Object
Patients
9. Hypertensive disease PROCESS_OF Patients
Subject
Hypertensive disease
Predicate
PROCESS_OF
Object
Patients
10. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
11. Hypertensive disease PREDISPOSES COVID-19
Subject
Hypertensive disease
Predicate
PREDISPOSES
Object
COVID-19
12. Laboratory Procedures USES TNFRSF11A protein, human|TNFRSF11A
Subject
Laboratory Procedures
Predicate
USES
Object
TNFRSF11A protein, human|TNFRSF11A
13. COVID-19 PROCESS_OF hospitalized patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
hospitalized patients
14. Adrenergic beta-Antagonists TREATS Hypertensive disease
Subject
Adrenergic beta-Antagonists
Predicate
TREATS
Object
Hypertensive disease
15. Adrenergic beta-Antagonists TREATS COVID-19
Subject
Adrenergic beta-Antagonists
Predicate
TREATS
Object
COVID-19
16. Adrenergic beta-Antagonists TREATS Patients
Subject
Adrenergic beta-Antagonists
Predicate
TREATS
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Patients
ABSTRACT

BACKGROUND:

Hypertension is considered an important risk factor for the coronavirus disease 2019 (COVID-19). The commonly anti-hypertensive drugs are the renin-angiotensin-aldosterone system (RAAS) inhibitors, calcium channel blockers (CCBs), and beta-blockers. The association between commonly used anti-hypertensive medications and the clinical outcome of COVID-19 patients with hypertension has not been well studied.

METHODS:

We conducted a retrospective cohort study that included all patients admitted with COVID-19 to Huo Shen Shan Hospital and Guanggu District of the Maternal and Child Health Hospital of Hubei Province, Wuhan, China. Clinical and laboratory characteristics were extracted from electronic medical records. Hypertension and anti-hypertensive treatment were confirmed by medical history and clinical records. The primary clinical endpoint was all-cause mortality. Secondary endpoints included the rates of patients in common wards transferred to the intensive care unit and hospital stay duration. Logistic regression was used to explore the risk factors associated with mortality and prognosis. Propensity score matching was used to balance the confounders between different anti-hypertensive treatments. Kaplan-Meier curves were used to compare the cumulative recovery rate. Log-rank tests were performed to test for differences in Kaplan-Meier curves between different groups.

RESULTS:

Among 4569 hospitalized patients with COVID-19, 31.7% (1449/4569) had a history of hypertension. There were significant differences in mortality rates between hypertensive patients with CCBs (7/359) and those without (21/359) (1.95% vs. 5.85%, risk ratio [RR] 0.32, 95% confidence interval [CI] 0.13-0.76, χ2 = 7.61, P = 0.0058). After matching for confounders, the mortality rates were similar between the RAAS inhibitor (4/236) and non-RAAS inhibitor (9/236) cohorts (1.69% vs. 3.81%, RR 0.43, 95% CI 0.13-1.43, χ2 = 1.98, P = 0.1596). Hypertensive patients with beta-blockers (13/340) showed no statistical difference in mortality compared with those without (11/340) (3.82% vs. 3.24%, RR 1.19, 95% CI 0.53-2.69, χ2 = 0.17, P = 0.6777).

CONCLUSIONS:

In our study, we did not find any positive or negative effects of RAAS inhibitors or beta-blockers in COVID-19 patients with hypertension, while CCBs could improve prognosis.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Hypertension Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Child / Humans Country/Region as subject: Asia Language: English Journal: Chin Med J (Engl) Year: 2021 Document Type: Article Affiliation country: CM9.0000000000001479

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Hypertension Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Child / Humans Country/Region as subject: Asia Language: English Journal: Chin Med J (Engl) Year: 2021 Document Type: Article Affiliation country: CM9.0000000000001479