Use of RAAS Inhibitors and Risk of Clinical Deterioration in COVID-19: Results From an Italian Cohort of 133 Hypertensives.

Autor:	Felice C; Acute and Emergency Department, Ca' Foncello Hospital, Treviso, Italy.; Department of Medicine-DIMED, Medicina Generale I^, Ca' Foncello Hospital, Treviso, University of Padova, Padua, Italy., Nardin C; Department of Medicine-DIMED, Medicina Generale I^, Ca' Foncello Hospital, Treviso, University of Padova, Padua, Italy., Di Tanna GL; The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia., Grossi U; Department of Surgical, Oncologic and Gastroenterological Sciences (DISCOG), Ca' Foncello Hospital, Treviso, University of Padua, Padua, Italy., Bernardi E; Acute and Emergency Department, Ca' Foncello Hospital, Treviso, Italy., Scaldaferri L; Acute and Emergency Department, Ca' Foncello Hospital, Treviso, Italy., Romagnoli M; Department of Specialistic and Laboratory Medicine Pulmonology Unit, Ca' Foncello Hospital, Treviso, Italy., Tonon L; Department of Medicine-DIMED, Medicina Generale I^, Ca' Foncello Hospital, Treviso, University of Padova, Padua, Italy., Cavasin P; Department of Medicine-DIMED, Medicina Generale I^, Ca' Foncello Hospital, Treviso, University of Padova, Padua, Italy., Novello S; Department of Surgical, Oncologic and Gastroenterological Sciences (DISCOG), Ca' Foncello Hospital, Treviso, University of Padua, Padua, Italy., Scarpa R; Department of Medicine-DIMED, Medicina Generale I^, Ca' Foncello Hospital, Treviso, University of Padova, Padua, Italy., Farnia A; Department of Anesthesia and Intensive Care, Ca' Foncello Hospital, Treviso, Italy., De Menis E; Department of Medicine, Medicina Generale II^, Ca' Foncello Hospital, Treviso, Italy., Rigoli R; Department of Specialistic and Laboratory Medicine, Microbiology Unit, Ca' Foncello Hospital, Treviso, Italy., Cinetto F; Department of Medicine-DIMED, Medicina Generale I^, Ca' Foncello Hospital, Treviso, University of Padova, Padua, Italy., Pauletto P; O.R.A.S. SpA, Ospedale Riabilitativo di Alta Specializzazione, Motta Di Livenza, Italy., Agostini C; Department of Medicine-DIMED, Medicina Generale I^, Ca' Foncello Hospital, Treviso, University of Padova, Padua, Italy., Rattazzi M; Department of Medicine-DIMED, Medicina Generale I^, Ca' Foncello Hospital, Treviso, University of Padova, Padua, Italy.
Jazyk:	angličtina
Zdroj:	American journal of hypertension [Am J Hypertens] 2020 Oct 21; Vol. 33 (10), pp. 944-948.
DOI:	10.1093/ajh/hpaa096
Abstrakt:	Background: The effect of chronic use of renin-angiotensin-aldosterone system (RAAS) inhibitors on the severity of COVID-19 infection is still unclear in patients with hypertension. We aimed to investigate the association between chronic use of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) and COVID-19-related outcomes in hypertensive patients. Methods: A single-center study was conducted on 133 consecutive hypertensive subjects presenting to the emergency department with acute respiratory symptoms and/or fever who were diagnosed with COVID-19 infection between 9 and 31 March 2020. Results: All patients were grouped according to their chronic antihypertensive medications (ACEIs, N = 40; ARBs, N = 42; not on RAAS inhibitors, N = 51). There was no statistical difference between ACEIs and ARBs groups in terms of hospital admission rate, oxygen therapy, and need for noninvasive ventilation. Patients chronically treated with RAAS inhibitors showed a significantly lower rate of admission to semi-intensive/intensive care units, when compared with the non-RAAS population (odds ratio (OR) 0.25, confidence interval (CI) 95% 0.09-0.66, P = 0.006). Similarly, the risk of mortality was lower in the former group, although not reaching statistical significance (OR 0.56, CI 95% 0.17-1.83, P = 0.341). Conclusions: Our data suggest that chronic use of RAAS inhibitors does not negatively affect clinical course of COVID-19 in hypertensive patients. Further studies are needed to confirm this finding and determine whether RAAS inhibitors may have a protective effect on COVID-19-related morbidity and mortality. (© American Journal of Hypertension, Ltd 2020. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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