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Estimation of Renin-Angiotensin-Aldosterone-System (RAAS)-Inhibitor effect on COVID-19 outcome: A Meta-analysis.
Pirola, Carlos J; Sookoian, Silvia.
  • Pirola CJ; University of Buenos Aires, School of Medicine, Institute of Medical Research A Lanari, Ciudad Autónoma de Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET)-University of Buenos Aires, Institute of Medical Research (IDIM), Department of Molecular Genetics and Biology of Complex Diseases, Ciudad Autónoma de Buenos Aires, Argentina. Electronic address: pirola.carlos@conicet.gov.ar.
  • Sookoian S; University of Buenos Aires, School of Medicine, Institute of Medical Research A Lanari, Ciudad Autónoma de Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET)-University of Buenos Aires, Institute of Medical Research (IDIM), Department of Clinical and Molecular Hepatology, Ciudad Autónoma de Buenos Aires, Argentina. Electronic address: ssookoian@intramed.net.
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 (n = 4134) vs. non-critical (n = 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 ∼ 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.
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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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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