Angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers and prognosis of hypertensive patients hospitalised with COVID-19.

Autor: Covino M; Emergency Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy., De Matteis G; Department of Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy., Burzo ML; Department of Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy., Santoro M; Emergency Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy., Fuorlo M; Emergency Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy., Sabia L; Emergency Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy., Sandroni C; Department of Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy., Gasbarrini A; Department of Anesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.; Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy., Franceschi F; Emergency Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.; Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy., Gambassi G; Department of Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.; Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome, Italy.
Jazyk: angličtina
Zdroj: Internal medicine journal [Intern Med J] 2020 Dec; Vol. 50 (12), pp. 1483-1491.
DOI: 10.1111/imj.15078
Abstrakt: Background: Among hypertensive patients, the association between treatment with angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II receptor blockers (ARB) and the clinical severity of COVID-19, remains uncertain.
Aims: To determine whether hypertensive patients hospitalised with COVID-19 are at risk of worse outcomes if on treatment with ACEI or ARB compared to other anti-hypertensive medications.
Methods: This is a retrospective study conducted at a single academic medical centre (Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy) from 1 to 31 March 2020. We compared patients on treatment with an ACEI/ARB (ACEI/ARB group) to patients receiving other anti-hypertensive medications (No-ACEI/ARB group). The end-points of the study were the all-cause in-hospital death and the combination of in-hospital death or need for intensive care unit (ICU) admission.
Results: The sample included 166 COVID-19 patients; median age was 74 years and 109 (66%) were men. Overall, 111 (67%) patients were taking an ACEI or ARB. Twenty-nine (17%) patients died during the hospital stay, and 51 (31%) met the combined end-point. After adjustment for comorbidities, age and degree of severity at the presentation, ACEI or ARB treatment was an independent predictor neither of in-hospital death nor of the combination of in-hospital death/need for ICU. No differences were documented between treatment with ACEI compared to ARB.
Conclusions: Among hypertensive patients hospitalised for COVID-19, treatment with ACEI or ARB is not associated with an increased risk of in-hospital death.
(© 2020 Royal Australasian College of Physicians.)
Databáze: MEDLINE
Externí odkaz: