Continued In-Hospital Angiotensin-Converting Enzyme Inhibitor and Angiotensin II Receptor Blocker Use in Hypertensive COVID-19 Patients Is Associated With Positive Clinical Outcome.
J Infect Dis
; 222(8): 1256-1264, 2020 09 14.
Article
in English
| MEDLINE | ID: covidwho-811306
ABSTRACT
BACKGROUND:
This study investigated continued and discontinued use of angiotensin-converting enzyme inhibitors (ACEi) or angiotensin II receptor blockers (ARB) during hospitalization of 614 hypertensive laboratory-confirmed COVID-19 patients.METHODS:
Demographics, comorbidities, vital signs, laboratory data, and ACEi/ARB usage were analyzed. To account for confounders, patients were substratified by whether they developed hypotension and acute kidney injury (AKI) during the index hospitalization.RESULTS:
Mortality (22% vs 17%, Pâ >â .05) and intensive care unit (ICU) admission (26% vs 12%, Pâ >â .05) rates were not significantly different between non-ACEi/ARB and ACEi/ARB groups. However, patients who continued ACEi/ARBs in the hospital had a markedly lower ICU admission rate (12% vs 26%; Pâ =â .001; odds ratio [OR]â =â 0.347; 95% confidence interval [CI], .187-.643) and mortality rate (6% vs 28%; Pâ =â .001; ORâ =â 0.215; 95% CI, .101-.455) compared to patients who discontinued ACEi/ARB. The odds ratio for mortality remained significantly lower after accounting for development of hypotension or AKI.CONCLUSIONS:
These findings suggest that continued ACEi/ARB use in hypertensive COVID-19 patients yields better clinical outcomes.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:
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
North America
Language:
English
Journal:
J Infect Dis
Year:
2020
Document Type:
Article
Affiliation country:
Infdis
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