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Angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers and prognosis of hypertensive patients hospitalised with COVID-19.
Covino, Marcello; De Matteis, Giuseppe; Burzo, Maria Livia; Santoro, Michele; Fuorlo, Mariella; Sabia, Luca; Sandroni, Claudio; Gasbarrini, Antonio; Franceschi, Francesco; Gambassi, Giovanni.
  • Covino M; Emergency Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
  • De Matteis G; Department of Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
  • Burzo ML; Department of Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
  • Santoro M; Emergency Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
  • Fuorlo M; Emergency Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
  • Sabia L; Emergency Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
  • Sandroni C; Department of Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
  • Gasbarrini A; Department of Anesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
  • Franceschi F; Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy.
  • Gambassi G; Emergency Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Intern Med J ; 50(12): 1483-1491, 2020 12.
Article in English | MEDLINE | ID: covidwho-998973
ABSTRACT

BACKGROUND:

Among hypertensive patients, the association between treatment with angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II receptor blockers (ARB) and the clinical severity of COVID-19, remains uncertain.

AIMS:

To determine whether hypertensive patients hospitalised with COVID-19 are at risk of worse outcomes if on treatment with ACEI or ARB compared to other anti-hypertensive medications.

METHODS:

This is a retrospective study conducted at a single academic medical centre (Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy) from 1 to 31 March 2020. We compared patients on treatment with an ACEI/ARB (ACEI/ARB group) to patients receiving other anti-hypertensive medications (No-ACEI/ARB group). The end-points of the study were the all-cause in-hospital death and the combination of in-hospital death or need for intensive care unit (ICU) admission.

RESULTS:

The sample included 166 COVID-19 patients; median age was 74 years and 109 (66%) were men. Overall, 111 (67%) patients were taking an ACEI or ARB. Twenty-nine (17%) patients died during the hospital stay, and 51 (31%) met the combined end-point. After adjustment for comorbidities, age and degree of severity at the presentation, ACEI or ARB treatment was an independent predictor neither of in-hospital death nor of the combination of in-hospital death/need for ICU. No differences were documented between treatment with ACEI compared to ARB.

CONCLUSIONS:

Among hypertensive patients hospitalised for COVID-19, treatment with ACEI or ARB is not associated with an increased risk of in-hospital death.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Angiotensin-Converting Enzyme Inhibitors / Angiotensin Receptor Antagonists / COVID-19 / Hospitalization / Hypertension Type of study: Diagnostic study / Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: Intern Med J Journal subject: Internal Medicine Year: 2020 Document Type: Article Affiliation country: Imj.15078

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Angiotensin-Converting Enzyme Inhibitors / Angiotensin Receptor Antagonists / COVID-19 / Hospitalization / Hypertension Type of study: Diagnostic study / Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: Intern Med J Journal subject: Internal Medicine Year: 2020 Document Type: Article Affiliation country: Imj.15078