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ABSTRACT: Introduction and objectives
Coronavirus disease (COVID-19) has been designated a global pandemic by the World Health Organization. It is unclear whether previous treatment with angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) affects the prognosis of COVID-19 patients. The aim of this study was to evaluate the clinical implications of previous treatment with ACEI/ARB on the prognosis of patients with COVID-19 infection.Methods
Single-center, retrospective, observational cohort study based on all the inhabitants of our health area. Analyses of main outcomes (mortality, heart failure, hospitalization, intensive care unit [ICU] admission, and major acute cardiovascular events [a composite of mortality and heart failure]) were adjusted by multivariate logistic regression and propensity score matching models.Results
Of the total population, 447 979 inhabitants, 965 patients (0.22%) were diagnosed with COVID-19 infection, and 210 (21.8%) were under ACEI or ARB treatment at the time of diagnosis. Treatment with ACEI/ARB (combined and individually) had no effect on mortality (OR, 0.62; 95%CI, 0.17-2.26; P = .486), heart failure (OR, 1.37; 95%CI, 0.39-4.77; P = .622), hospitalization rate (OR, 0.85; 95%CI, 0.45-1.64; P = .638), ICU admission (OR, 0.87; 95%CI, 0.30-2.50; P = .798), or major acute cardiovascular events (OR, 1.06; 95%CI, 0.39-2.83; P = .915). This neutral effect remained in a subgroup analysis of patients requiring hospitalization.Conclusions
Previous treatment with ACEI/ARB in patients with COVID-19 had no effect on mortality, heart failure, requirement for hospitalization, or ICU admission. Withdrawal of ACEI/ARB in patients testing positive for COVID-19 would not be justified, in line with current recommendations of scientific societies and government agencies.
SUBMITTER: Lopez-Otero D
PROVIDER: S-EPMC7368901 | biostudies-literature | 2021 Feb
REPOSITORIES: biostudies-literature
López-Otero Diego D López-Pais Javier J Cacho-Antonio Carla Eugenia CE Antúnez-Muiños Pablo José PJ González-Ferrero Teba T Pérez-Poza Marta M Otero-García Óscar Ó Díaz-Fernández Brais B Bastos-Fernández María M Bouzas-Cruz Noelia N Sanmartín-Pena Xoan Carlos XC Varela-Román Alfonso A Portela-Romero Manuel M Valdés-Cuadrado Luis L Pose-Reino Antonio A González-Juanatey José Ramón JR
Revista espanola de cardiologia 20200719 2
<h4>Introduction and objectives</h4>Coronavirus disease (COVID-19) has been designated a global pandemic by the World Health Organization. It is unclear whether previous treatment with angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) affects the prognosis of COVID-19 patients. The aim of this study was to evaluate the clinical implications of previous treatment with ACEI/ARB on the prognosis of patients with COVID-19 infection.<h4>Methods</h4>Single-center, ...[more]