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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
Volume 8, Issue 5, September 2020, Pages: 204-210
Received: Jul. 21, 2020; Accepted: Aug. 3, 2020; Published: Aug. 18, 2020
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Authors
Patricia Díaz-Guardiola, Department of Endocrinology and Nutrition, Infanta Sofía University Hospital, San Sebastián de los Reyes, Spain; Faculty of Medicine, European University of Madrid, Madrid, Spain
Virginia Martín-Borge, Department of Endocrinology and Nutrition, Infanta Sofía University Hospital, San Sebastián de los Reyes, Spain; Faculty of Medicine, European University of Madrid, Madrid, Spain
Cristina García-Fernández, Department of Preventive Medicine, Infanta Sofía University Hospital, San Sebastián de los Reyes, Spain; Faculty of Medicine, European University of Madrid, Madrid, Spain
María Teresa Ramírez-Prieto, Department of Pneumology, Infanta Sofía University Hospital, San Sebastián de los Reyes, Spain; Faculty of Medicine, European University of Madrid, Madrid, Spain
Marcela Irma Ramírez-Belmar, Department of Endocrinology and Nutrition, Infanta Sofía University Hospital, San Sebastián de los Reyes, Spain
Gema García-Romero, Department of Endocrinology and Nutrition, Infanta Sofía University Hospital, San Sebastián de los Reyes, Spain; Faculty of Medicine, European University of Madrid, Madrid, Spain
Esther de la Calle, Department of Endocrinology and Nutrition, Infanta Sofía University Hospital, San Sebastián de los Reyes, Spain
José Antonio Balsa, 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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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.
Keywords
ACEI/ARB, COVID-19 Severity, COVID-19 Mortality
To cite this article
Patricia Díaz-Guardiola, Virginia Martín-Borge, Cristina García-Fernández, María Teresa Ramírez-Prieto, Marcela Irma Ramírez-Belmar, Gema García-Romero, Esther de la Calle, José Antonio Balsa, 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. Vol. 8, No. 5, 2020, pp. 204-210. doi: 10.11648/j.ajim.20200805.12
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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