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Use of RAAS Inhibitors and Risk of Clinical Deterioration in COVID-19: Results From an Italian Cohort of 133 Hypertensives.
Felice, Carla; Nardin, Chiara; Di Tanna, Gian Luca; Grossi, Ugo; Bernardi, Enrico; Scaldaferri, Luca; Romagnoli, Micaela; Tonon, Luca; Cavasin, Paola; Novello, Simone; Scarpa, Riccardo; Farnia, Antonio; De Menis, Ernesto; Rigoli, Roberto; Cinetto, Francesco; Pauletto, Paolo; Agostini, Carlo; Rattazzi, Marcello.
  • Felice C; Acute and Emergency Department, Ca' Foncello Hospital, Treviso, Italy.
  • Nardin C; Department of Medicine-DIMED, Medicina Generale I
  • Di Tanna GL; Department of Medicine-DIMED, Medicina Generale I
  • Grossi U; The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.
  • Bernardi E; Department of Surgical, Oncologic and Gastroenterological Sciences (DISCOG), Ca' Foncello Hospital, Treviso, University of Padua, Padua, Italy.
  • Scaldaferri L; Acute and Emergency Department, Ca' Foncello Hospital, Treviso, Italy.
  • Romagnoli M; Acute and Emergency Department, Ca' Foncello Hospital, Treviso, Italy.
  • Tonon L; Department of Specialistic and Laboratory Medicine Pulmonology Unit, Ca' Foncello Hospital, Treviso, Italy.
  • Cavasin P; Department of Medicine-DIMED, Medicina Generale I
  • Novello S; Department of Medicine-DIMED, Medicina Generale I
  • Scarpa R; Department of Surgical, Oncologic and Gastroenterological Sciences (DISCOG), Ca' Foncello Hospital, Treviso, University of Padua, Padua, Italy.
  • Farnia A; Department of Medicine-DIMED, Medicina Generale I
  • De Menis E; Department of Anesthesia and Intensive Care, Ca' Foncello Hospital, Treviso, Italy.
  • Rigoli R; Department of Medicine, Medicina Generale II
  • Cinetto F; Department of Specialistic and Laboratory Medicine, Microbiology Unit, Ca' Foncello Hospital, Treviso, Italy.
  • Pauletto P; Department of Medicine-DIMED, Medicina Generale I
  • Agostini C; O.R.A.S. SpA, Ospedale Riabilitativo di Alta Specializzazione, Motta Di Livenza, Italy.
  • Rattazzi M; Department of Medicine-DIMED, Medicina Generale I
Am J Hypertens ; 33(10): 944-948, 2020 10 21.
Article in English | MEDLINE | ID: covidwho-574682
Semantic information from SemMedBD (by NLM)
1. Clinical Deterioration ASSOCIATED_WITH COVID-19
Subject
Clinical Deterioration
Predicate
ASSOCIATED_WITH
Object
COVID-19
2. Hypertensive disease PROCESS_OF Patients
Subject
Hypertensive disease
Predicate
PROCESS_OF
Object
Patients
3. Angiotensin-Converting Enzyme Inhibitors TREATS Patients
Subject
Angiotensin-Converting Enzyme Inhibitors
Predicate
TREATS
Object
Patients
4. Angiotensin II receptor antagonist TREATS Patients
Subject
Angiotensin II receptor antagonist
Predicate
TREATS
Object
Patients
5. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
6. Clinical Deterioration ASSOCIATED_WITH COVID-19
Subject
Clinical Deterioration
Predicate
ASSOCIATED_WITH
Object
COVID-19
7. Hypertensive disease PROCESS_OF Patients
Subject
Hypertensive disease
Predicate
PROCESS_OF
Object
Patients
8. Angiotensin-Converting Enzyme Inhibitors TREATS Patients
Subject
Angiotensin-Converting Enzyme Inhibitors
Predicate
TREATS
Object
Patients
9. Angiotensin II receptor antagonist TREATS Patients
Subject
Angiotensin II receptor antagonist
Predicate
TREATS
Object
Patients
10. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
ABSTRACT

BACKGROUND:

The effect of chronic use of renin-angiotensin-aldosterone system (RAAS) inhibitors on the severity of COVID-19 infection is still unclear in patients with hypertension. We aimed to investigate the association between chronic use of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) and COVID-19-related outcomes in hypertensive patients.

METHODS:

A single-center study was conducted on 133 consecutive hypertensive subjects presenting to the emergency department with acute respiratory symptoms and/or fever who were diagnosed with COVID-19 infection between 9 and 31 March 2020.

RESULTS:

All patients were grouped according to their chronic antihypertensive medications (ACEIs, N = 40; ARBs, N = 42; not on RAAS inhibitors, N = 51). There was no statistical difference between ACEIs and ARBs groups in terms of hospital admission rate, oxygen therapy, and need for noninvasive ventilation. Patients chronically treated with RAAS inhibitors showed a significantly lower rate of admission to semi-intensive/intensive care units, when compared with the non-RAAS population (odds ratio (OR) 0.25, confidence interval (CI) 95% 0.09-0.66, P = 0.006). Similarly, the risk of mortality was lower in the former group, although not reaching statistical significance (OR 0.56, CI 95% 0.17-1.83, P = 0.341).

CONCLUSIONS:

Our data suggest that chronic use of RAAS inhibitors does not negatively affect clinical course of COVID-19 in hypertensive patients. Further studies are needed to confirm this finding and determine whether RAAS inhibitors may have a protective effect on COVID-19-related morbidity and mortality.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Angiotensin-Converting Enzyme Inhibitors / Coronavirus Infections / Angiotensin Receptor Antagonists / Hypertension Type of study: Etiology study / Observational study / Randomized controlled trials / Risk factors Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Am J Hypertens Journal subject: Vascular Diseases Year: 2020 Document Type: Article Affiliation country: Ajh

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Angiotensin-Converting Enzyme Inhibitors / Coronavirus Infections / Angiotensin Receptor Antagonists / Hypertension Type of study: Etiology study / Observational study / Randomized controlled trials / Risk factors Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Am J Hypertens Journal subject: Vascular Diseases Year: 2020 Document Type: Article Affiliation country: Ajh