RENIN-ANGIOTENSIN SYSTEM BLOCKER AND THE COVID-19 AGGRAVATION: REPORT BY THE COVID-19 REGISTRY JAPAN
Journal of Hypertension
; 41:e306, 2023.
Article
in English
| EMBASE | ID: covidwho-2246605
ABSTRACT
Objective:
The role of angiotensin converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB) in the pandemic context of coronavirus disease 2019 (COVID-19) continues to be debated. Patients with hypertension, diabetes mellitus, chronic renal failure, cerebro-cardiovascular disease, or chronic obstructive pulmonary disease (COPD), who often use ACEi/ARB, may affect risk of severe COVID-19. However, there are no data available on the association of ACEi/ARB use with COVID-19 severity in this population. Design andmethod:
This study is an observational study of patients with a positive SARS-CoV-2 test and inpatient treatment at a healthcare facility, using the registry information of COVIREGI-JP. Our primary outcomes were consisting of in-hospital death, ventilator support, extracorporeal membrane oxygenation support, and ICU admission. Out of the 6,055 patients, 1,921 patients with preexisting hypertension, diabetes mellitus, chronic renal failure, cerebro-cardiovascular disease, or COPD were enrolled. We also evaluated 1,097 patients with hypertension.Results:
Factors associated with an increased risk of the primary outcomes were aging, male sex, COPD, severe renal impairment, and diabetes mellitus. No correlations were observed with ACEi/ARB, cerebro-cardiovascular diseases, or hypertension. Associated factors in male patients were aging, renal impairment, hypertension, and diabetes. In female patients, factors associated with an increased risk were aging, ACEi/ARB, renal impairment, and diabetes, whereas hypertension was associated with a lower risk of the primary outcomes. In patients with hypertension, factors associated with an increased risk of the primary outcomes were aging, male sex, severe renal impairment, and diabetes mellitus, but not ACEi/ ARB, cerebro-cardiovascular diseases, or COPD.Conclusions:
Independent factors for the primary outcomes were aging, male sex, COPD, severe renal impairment, and diabetes, but not ACEi/ARB, in the COVID-19 patients with preexisting hypertension, diabetes mellitus, chronic renal failure, cerebro-cardiovascular disease or COPD. Based on this registry data analysis, more detailed data collection and analysis is needed with the cooperation of multiple healthcare facilities.
angiotensin receptor antagonist; dipeptidyl carboxypeptidase inhibitor; adult; aging; artificial ventilation; cardiovascular disease; chronic kidney failure; chronic obstructive lung disease; clinical evaluation; conference abstract; coronavirus disease 2019; COVID-19 testing; data analysis; diabetes mellitus; disease exacerbation; drug combination; extracorporeal oxygenation; female; health care facility; hospital patient; human; hypertension; in-hospital mortality; Japan; kidney disease; major clinical study; male; observational study; outcome assessment; renin angiotensin aldosterone system; severe renal impairment; ventilator
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Collection:
Databases of international organizations
Database:
EMBASE
Language:
English
Journal:
Journal of Hypertension
Year:
2023
Document Type:
Article
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