American Journal of Internal Medicine

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Association of Use of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers with Coronavirus Disease 2019 Severity and Mortality

Received: 21 July 2020    Accepted: 03 August 2020    Published: 18 August 2020
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Abstract

Background: A potential association between use of angiotensin-converting–enzyme inhibitors (ACEI) or angiotensin-receptor blockers (ARB) and coronavirus disease 2019 (COVID-19) severity has been suggested. We conducted a retrospective study to investigate the association between ACEI/ARB use and COVID-19 severity and mortality. Methods: The first 1,000 consecutive patients with COVID-19 who were attended in the emergency department at the Infanta Sofía University Hospital were included. Clinical data was manually extracted by reviewing medical records, and the ACEI/ARB prescription was assessed from an electronic pharmacy database. The primary endpoints were critical COVID-19 and mortality. Results: A total of 241 (24.1%) patients had a critical COVID-19 and 171 (17.1%) died. ACEI use was associated with critical COVID-19 (OR 1.90, 95% CI 1.34-2.70), and with mortality (OR 1.98, 95% CI 1.35-2.91) in the unadjusted analysis, but not after adjusting by age, sex and comorbidities (OR 1.15 95% CI 0.69-1.94, and OR 1.00 95% CI 0.56-1.77, respectively). Similarly, ARB use was associated with critical COVID-19 (OR 1.58, 95% CI 1.11-2.58), although not with mortality (OR 1.47, 95% CI 0.98-2.19) in the unadjusted analysis, but not after adjusting by age, sex and comorbidities (OR 0.97, 95% CI 0.57-1.65, and OR 0.74, 95% CI 0.41-1.33, respectively). Conclusion: These results suggest that the use of ACEI/ARB is not independently associated with COVID-19 severity and mortality.

DOI 10.11648/j.ajim.20200805.12
Published in American Journal of Internal Medicine (Volume 8, Issue 5, September 2020)
Page(s) 204-210
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

ACEI/ARB, COVID-19 Severity, COVID-19 Mortality

References
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Author Information
  • Department of Endocrinology and Nutrition, Infanta Sofía University Hospital, San Sebastián de los Reyes, Spain; Faculty of Medicine, European University of Madrid, Madrid, Spain

  • Department of Endocrinology and Nutrition, Infanta Sofía University Hospital, San Sebastián de los Reyes, Spain; Faculty of Medicine, European University of Madrid, Madrid, Spain

  • Department of Preventive Medicine, Infanta Sofía University Hospital, San Sebastián de los Reyes, Spain; Faculty of Medicine, European University of Madrid, Madrid, Spain

  • Department of Pneumology, Infanta Sofía University Hospital, San Sebastián de los Reyes, Spain; Faculty of Medicine, European University of Madrid, Madrid, Spain

  • Department of Endocrinology and Nutrition, Infanta Sofía University Hospital, San Sebastián de los Reyes, Spain

  • Department of Endocrinology and Nutrition, Infanta Sofía University Hospital, San Sebastián de los Reyes, Spain; Faculty of Medicine, European University of Madrid, Madrid, Spain

  • Department of Endocrinology and Nutrition, Infanta Sofía University Hospital, San Sebastián de los Reyes, Spain

  • Department of Endocrinology and Nutrition, Infanta Sofía University Hospital, San Sebastián de los Reyes, Spain; Faculty of Medicine, European University of Madrid, Madrid, Spain

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  • APA Style

    Patricia Díaz-Guardiola, Virginia Martín-Borge, Cristina García-Fernández, María Teresa Ramírez-Prieto, Marcela Irma Ramírez-Belmar, et al. (2020). Association of Use of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers with Coronavirus Disease 2019 Severity and Mortality. American Journal of Internal Medicine, 8(5), 204-210. https://doi.org/10.11648/j.ajim.20200805.12

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    ACS Style

    Patricia Díaz-Guardiola; Virginia Martín-Borge; Cristina García-Fernández; María Teresa Ramírez-Prieto; Marcela Irma Ramírez-Belmar, et al. Association of Use of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers with Coronavirus Disease 2019 Severity and Mortality. Am. J. Intern. Med. 2020, 8(5), 204-210. doi: 10.11648/j.ajim.20200805.12

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    AMA Style

    Patricia Díaz-Guardiola, Virginia Martín-Borge, Cristina García-Fernández, María Teresa Ramírez-Prieto, Marcela Irma Ramírez-Belmar, et al. Association of Use of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers with Coronavirus Disease 2019 Severity and Mortality. Am J Intern Med. 2020;8(5):204-210. doi: 10.11648/j.ajim.20200805.12

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  • @article{10.11648/j.ajim.20200805.12,
      author = {Patricia Díaz-Guardiola and Virginia Martín-Borge and Cristina García-Fernández and María Teresa Ramírez-Prieto and Marcela Irma Ramírez-Belmar and Gema García-Romero and Esther de la Calle and José Antonio Balsa},
      title = {Association of Use of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers with Coronavirus Disease 2019 Severity and Mortality},
      journal = {American Journal of Internal Medicine},
      volume = {8},
      number = {5},
      pages = {204-210},
      doi = {10.11648/j.ajim.20200805.12},
      url = {https://doi.org/10.11648/j.ajim.20200805.12},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ajim.20200805.12},
      abstract = {Background: A potential association between use of angiotensin-converting–enzyme inhibitors (ACEI) or angiotensin-receptor blockers (ARB) and coronavirus disease 2019 (COVID-19) severity has been suggested. We conducted a retrospective study to investigate the association between ACEI/ARB use and COVID-19 severity and mortality. Methods: The first 1,000 consecutive patients with COVID-19 who were attended in the emergency department at the Infanta Sofía University Hospital were included. Clinical data was manually extracted by reviewing medical records, and the ACEI/ARB prescription was assessed from an electronic pharmacy database. The primary endpoints were critical COVID-19 and mortality. Results: A total of 241 (24.1%) patients had a critical COVID-19 and 171 (17.1%) died. ACEI use was associated with critical COVID-19 (OR 1.90, 95% CI 1.34-2.70), and with mortality (OR 1.98, 95% CI 1.35-2.91) in the unadjusted analysis, but not after adjusting by age, sex and comorbidities (OR 1.15 95% CI 0.69-1.94, and OR 1.00 95% CI 0.56-1.77, respectively). Similarly, ARB use was associated with critical COVID-19 (OR 1.58, 95% CI 1.11-2.58), although not with mortality (OR 1.47, 95% CI 0.98-2.19) in the unadjusted analysis, but not after adjusting by age, sex and comorbidities (OR 0.97, 95% CI 0.57-1.65, and OR 0.74, 95% CI 0.41-1.33, respectively). Conclusion: These results suggest that the use of ACEI/ARB is not independently associated with COVID-19 severity and mortality.},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - Association of Use of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers with Coronavirus Disease 2019 Severity and Mortality
    AU  - Patricia Díaz-Guardiola
    AU  - Virginia Martín-Borge
    AU  - Cristina García-Fernández
    AU  - María Teresa Ramírez-Prieto
    AU  - Marcela Irma Ramírez-Belmar
    AU  - Gema García-Romero
    AU  - Esther de la Calle
    AU  - José Antonio Balsa
    Y1  - 2020/08/18
    PY  - 2020
    N1  - https://doi.org/10.11648/j.ajim.20200805.12
    DO  - 10.11648/j.ajim.20200805.12
    T2  - American Journal of Internal Medicine
    JF  - American Journal of Internal Medicine
    JO  - American Journal of Internal Medicine
    SP  - 204
    EP  - 210
    PB  - Science Publishing Group
    SN  - 2330-4324
    UR  - https://doi.org/10.11648/j.ajim.20200805.12
    AB  - Background: A potential association between use of angiotensin-converting–enzyme inhibitors (ACEI) or angiotensin-receptor blockers (ARB) and coronavirus disease 2019 (COVID-19) severity has been suggested. We conducted a retrospective study to investigate the association between ACEI/ARB use and COVID-19 severity and mortality. Methods: The first 1,000 consecutive patients with COVID-19 who were attended in the emergency department at the Infanta Sofía University Hospital were included. Clinical data was manually extracted by reviewing medical records, and the ACEI/ARB prescription was assessed from an electronic pharmacy database. The primary endpoints were critical COVID-19 and mortality. Results: A total of 241 (24.1%) patients had a critical COVID-19 and 171 (17.1%) died. ACEI use was associated with critical COVID-19 (OR 1.90, 95% CI 1.34-2.70), and with mortality (OR 1.98, 95% CI 1.35-2.91) in the unadjusted analysis, but not after adjusting by age, sex and comorbidities (OR 1.15 95% CI 0.69-1.94, and OR 1.00 95% CI 0.56-1.77, respectively). Similarly, ARB use was associated with critical COVID-19 (OR 1.58, 95% CI 1.11-2.58), although not with mortality (OR 1.47, 95% CI 0.98-2.19) in the unadjusted analysis, but not after adjusting by age, sex and comorbidities (OR 0.97, 95% CI 0.57-1.65, and OR 0.74, 95% CI 0.41-1.33, respectively). Conclusion: These results suggest that the use of ACEI/ARB is not independently associated with COVID-19 severity and mortality.
    VL  - 8
    IS  - 5
    ER  - 

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