ANGIOTENSIN-CONVERTING ENZYME INHIBITORS AND ANGIOTENSIN II RECEPTOR BLOCKERS AS A RISK FACTOR FOR PATIENTS HOSPITALIZED WITH COVID-19. IS THAT TRUE?

ABSTRACT

Objective: The link with angiotensin-converting-enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) is because of the known association between angiotensin-converting enzyme 2 (ACE) and SARS-COV 2. ACE 2 has been shown to be a co-receptor for viral entry for SARS-COV-2 in the respiratory epithelium. It has been a global concern that the use of this drugs may be a risk for patients with COVID-19 infection. It has been published many studies about this subject. Even today there are still controversies regarding to the impact of these drugs. The aim of this study was to determine the association between the previous use of ACEI/ARB and the prognosis of patients with COVID-19 infection Design and method: Single-center, restrospective, cohort study included 608 patients with hypertension diagnosed with COVID-19, who where hospitalized in Macarena's hospital from Mars to December 2020. Analyses of main outcomes (mortality, need of intensive cares (ICU), and days of mean study) were adjusted by multivariate logistic regression. Results: Of a total population of 500,000, 608 patients (0.12%) required admission for COVID-19. A total of 83.7% were hypertensive, specifically 75.9% were under antihypertensive treatment (35.7% with only 1 drug, 29.9% were taking two drugs, 9% with three drugs, and 1.3% with 4 drugs). 26.2% were treated with an ACEI and 24.8% with ARBs. Treatment with ACEI / ARB-II (combined or individually) had no impact on mortality (OR = 1.29;95% CI, 0.829-2.014;p = 0.257), nor ICU admission (OR = 1, 7;95% CI, 0.68 - 4.95;p = 0.232), nor on the days of mean stay (OR = 0.98;95% CI, 0.95-1.04;p = 0.325). Conclusions: It is unlikely that previous treatment with ACEI/ARB was associated with an increased mortality risk, neither ICU admission or an increase in days of mean stay. This study supports current guidelines that discourage discontinuation of ACEIS or ARBs in COVID-19 patients.