ABSTRACT
Background/Aims@#Since the onset of the coronavirus disease 2019 (COVID-19) pandemic, there have been concerns about the association between exposure to renin-angiotensin-aldosterone system (RAAS) inhibitors and the risk and severity of COVID-19. @*Methods@#We performed a case-control study that utilized up-to-date data on the South Korean population provided by the Korean National Health Insurance System. Of the 62,909 patients with hypertension or heart failure tested for COVID-19, there were 1,644 (2.6%) confirmed cases. After case-control matching, multivariable-adjusted conditional logistic regression analysis was performed. @*Results@#Comparison between patients exposed to RAAS inhibitors and those not exposed to RAAS inhibitors revealed that the adjusted odds ratio (OR) and 95% confidence interval (CI) for COVID-19 infection and death were 0.981 (95% CI, 0.849 to 1.135) and 0.875 (95% CI, 0.548 to 1.396), respectively. Subgroup analysis for the major confounders, age and region of diagnosis, resulted in OR of 0.912 (95% CI, 0.751 to 1.108) and 0.942 (95% CI, 0.791 to 1.121), respectively. @*Conclusions@#The present study demonstrated no evidence of association between RAAS inhibitor exposure and risk and severity of COVID-19.
ABSTRACT
Background/Aims@#The impact of liver cirrhosis (LC) on the clinical outcomes of patients with coronavirus disease 2019 (COVID-19) remains elusive. This study evaluated the association between LC and the development of severe complications from COVID-19. @*Methods@#We used the National Health Insurance claims data of Korea. We included 234,427 patients older than 19 years who tested for severe acute respiratory syndrome coronavirus 2. Patients with LC who were infected with COVID-19 (n = 67, LC+ COVID+) were matched with those with cirrhosis only (n = 332, LC+ COVID–) and those with COVID-19 only (n = 333, LC– COVID+) using a propensity score in a 1:5 ratio. The primary outcome was the development of severe complications. @*Results@#Of the matched patients, the mean age was 60 years and 59.7% were male. Severe complications occurred in 18, 54, and 60 patients in the LC+ COVID+, LC+ COVID–, and LC– COVID+ groups, respectively. After adjusting for comorbidities, there was no significant difference in the risk of developing severe complications from COVID-19 between the LC+ COVID+ and LC– COVID+ groups but significant difference exists between the LC+ COVID+ and LC+ COVID–. Older age, hypertension, cancer, chronic obstructive pulmonary disease, and a higher Charlson comorbidity index were associated with a higher risk of severe complications in patients with cirrhosis and COVID-19. @*Conclusions@#Our study suggests that LC was not independently associated with the development of severe complications, including mortality, in patients with COVID-19. Our results need to be evaluated through a large, prospective study.
ABSTRACT
Background/Aims@#The impact of liver cirrhosis (LC) on the clinical outcomes of patients with coronavirus disease 2019 (COVID-19) remains elusive. This study evaluated the association between LC and the development of severe complications from COVID-19. @*Methods@#We used the National Health Insurance claims data of Korea. We included 234,427 patients older than 19 years who tested for severe acute respiratory syndrome coronavirus 2. Patients with LC who were infected with COVID-19 (n = 67, LC+ COVID+) were matched with those with cirrhosis only (n = 332, LC+ COVID–) and those with COVID-19 only (n = 333, LC– COVID+) using a propensity score in a 1:5 ratio. The primary outcome was the development of severe complications. @*Results@#Of the matched patients, the mean age was 60 years and 59.7% were male. Severe complications occurred in 18, 54, and 60 patients in the LC+ COVID+, LC+ COVID–, and LC– COVID+ groups, respectively. After adjusting for comorbidities, there was no significant difference in the risk of developing severe complications from COVID-19 between the LC+ COVID+ and LC– COVID+ groups but significant difference exists between the LC+ COVID+ and LC+ COVID–. Older age, hypertension, cancer, chronic obstructive pulmonary disease, and a higher Charlson comorbidity index were associated with a higher risk of severe complications in patients with cirrhosis and COVID-19. @*Conclusions@#Our study suggests that LC was not independently associated with the development of severe complications, including mortality, in patients with COVID-19. Our results need to be evaluated through a large, prospective study.
