Article ; Online: Clinical outcomes of COVID-19 following the use of angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers among patients with hypertension in Korea: a nationwide study.
2020 Volume 43, Page(s) e2021004
Abstract: ... of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin-receptor blockers (ARBs) in patients with coronavirus disease 2019 (COVID ... clinical evidence to support continuing ACE/ARB use in COVID-19 patients with hypertension based ... clinical outcomes of COVID-19.: Methods: From the completely enumerated COVID-19 cohort in Korea ...
| Abstract | Objectives: Recent evidence has shown no harm associated with the use of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin-receptor blockers (ARBs) in patients with coronavirus disease 2019 (COVID-19). We sought to further clarify the possible association between ACEI/ARB use and the risk of poor clinical outcomes of COVID-19. Methods: From the completely enumerated COVID-19 cohort in Korea, we identified 1,290 patients with hypertension, of whom 682 had and 603 did not have records of ACEI/ARB use during the 30-day period before their COVID-19 diagnosis. Our primary endpoint comprised clinical outcomes, including all-cause mortality, use of mechanical ventilation, intensive care unit admission, and sepsis. We used inverse probability of treatment weighting (IPTW) to mitigate selection bias, and a Poisson regression model to estimate the relative risks (RRs) and 95% confidence intervals (CIs) for comparing outcomes between ACEI/ARB users and non-users. Results: Compared to non-use, ACEI/ARB use was associated with lower clinical outcomes (IPTW-adjusted RR, 0.60; 95% CI, 0.42 to 0.85; p=0.005). For individual outcomes, ACEI/ARB use was not associated with all-cause mortality (IPTW-adjusted RR, 0.62; 95% CI, 0.35 to 1.09; p=0.097) or respiratory events (IPTW-adjusted RR, 0.99; 95% CI, 0.84 to 1.17; p=0.904). Subgroup analysis showed a trend toward a protective role of ACEIs and ARBs against overall outcomes in men (IPTW-adjusted RR, 0.84; 95% CI, 0.69 to 1.03; pinteraction=0.008) and patients with pre-existing respiratory disease (IPTW-adjusted RR, 0.74; 95% CI, 0.60 to 0.92; pinteraction=0.002). Conclusions: We present clinical evidence to support continuing ACE/ARB use in COVID-19 patients with hypertension based on the completely enumerated Korean cohort. |
|---|---|
| MeSH term(s) | Adult ; Aged ; Aged, 80 and over ; Angiotensin Receptor Antagonists/therapeutic use ; Angiotensin-Converting Enzyme Inhibitors/therapeutic use ; COVID-19/drug therapy ; COVID-19/epidemiology ; Cohort Studies ; Female ; Humans ; Hypertension/drug therapy ; Hypertension/epidemiology ; Male ; Middle Aged ; Republic of Korea/epidemiology ; Treatment Outcome |
| Chemical Substances | Angiotensin Receptor Antagonists ; Angiotensin-Converting Enzyme Inhibitors |
| Language | English |
| Publishing date | 2020-12-29 |
| Publishing country | Korea (South) |
| Document type | Journal Article |
| ZDB-ID | 2590698-7 |
| ISSN | 2092-7193 ; 2092-7193 |
| ISSN (online) | 2092-7193 |
| ISSN | 2092-7193 |
| DOI | 10.4178/epih.e2021004 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
More links
Kategorien
Order via subito
This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.