Estimation of Renin-Angiotensin-Aldosterone-System (RAAS)-Inhibitor effect on COVID-19 outcome: A Meta-analysis.
J Infect
; 81(2): 276-281, 2020 08.
Article
in English
| MEDLINE | ID: covidwho-590639
ABSTRACT
BACKGROUND AND RATIONALE Some studies of hospitalized patients suggested that the risk of death and/or severe illness due to COVID-19 is not associated with the use of angiotensin-converting enzyme inhibitors (ACEIs) and/or angiotensin II receptor type 1 blockers (ARBs). Nevertheless, some controversy still exists and there is limited information of the ACEIs/ARBs effect size on COVID-19 prognosis. AIM AND METHODS:
We aimed to measure the effect of ACEIs and/or ARBs on COVID-19 severe clinical illness by a meta-analysis. Literature search included all studies published since the COVID-19 outbreak began (December 2019) until May 9, 2020. We analyzed information from studies that included tested COVID-19 patients with arterial hypertension as comorbidity prior to hospital admission and history of taking ACEIs, ARBs, or ACEIs/ARBs.RESULTS:
We included 16 studies that involved 24,676 COVID-19 patients, and we compared patients with critical (nâ¯=â¯4134) vs. non-critical (nâ¯=â¯20,542) outcomes. The overall assessment by estimating random effects shows that the use of ACEIs/ARBs is not associated with higher risk of in-hospital-death and/or severe illness among hypertensive patients with COVID-19 infection. On the contrary, effect estimate shows an overall protective effect of RAAS inhibitors/blockers (ACEIs, ARBs, and/or ACEIs/ARBs) with â¼ 23 % reduced risk of death and/or critical disease (OR 0.768, 95%CI 0.651-0.907, p=0.0018). The use of ACEIs (OR0.652, 95%CI0.478-0.891, p=0.0072) but not ACEIs/ARBs (OR0.867, 95%CI0.638-1.179, p =NS) or ARBs alone (OR0.810, 95%CI0.629-1.044, p=NS) may explain the overall protection displayed by RAAS intervention combined.CONCLUSION:
RAAS inhibitors might be associated with better COVID-19 prognosis.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Renin-Angiotensin System
/
Angiotensin-Converting Enzyme Inhibitors
/
Coronavirus Infections
/
Angiotensin II Type 1 Receptor Blockers
/
Hypertension
Type of study:
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
/
Reviews
Topics:
Long Covid
Limits:
Humans
Language:
English
Journal:
J Infect
Year:
2020
Document Type:
Article
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