Mortality and Severity in COVID-19 Patients on ACEIs and ARBs-A Systematic Review, Meta-Analysis, and Meta-Regression Analysis.

Autor:	Singh R; Department of Anesthesiology and Critical Care Medicine, Mayo Clinic, Rochester, MN, United States., Rathore SS; Dr. Sampurnanand Medical College and Hospital, Jodhpur, India., Khan H; Department of Internal Medicine, Islamic International Medical College, Rawalpindi, Pakistan., Bhurwal A; Department of Gastroenterology and Hepatology, Rutgers Robert Wood Johnson School of Medicine, New Brunswick, NJ, United States., Sheraton M; Department of Emergency Medicine, Trinity West Medical Center, Steubenville, OH, United States., Ghosh P; Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, United States., Anand S; Patliputra Medical College and Hospital, Dhanbad, India., Makadia J; GMERS Medical College and Hospital, Vadodara, India., Ayesha F; Department of Internal Medicine, Services Institute of Medical Sciences, Lahore, Pakistan., Mahapure KS; Department of Plastic Surgery, KAHER J. N. Medical College, Belgaum, India., Mehra I; Department of Internal Medicine, North Alabama Medical Center, Florence, AL, United States., Tekin A; Department of Anesthesiology and Critical Care Medicine, Mayo Clinic, Rochester, MN, United States., Kashyap R; Department of Anesthesiology and Critical Care Medicine, Mayo Clinic, Rochester, MN, United States., Bansal V; Department of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, United States.
Jazyk:	angličtina
Zdroj:	Frontiers in medicine [Front Med (Lausanne)] 2022 Jan 10; Vol. 8, pp. 703661. Date of Electronic Publication: 2022 Jan 10 (Print Publication: 2021).
DOI:	10.3389/fmed.2021.703661
Abstrakt:	Purpose: The primary objective of this systematic review is to assess association of mortality in COVID-19 patients on Angiotensin-converting-enzyme inhibitors (ACEIs) and Angiotensin-II receptor blockers (ARBs). A secondary objective is to assess associations with higher severity of the disease in COVID-19 patients. Materials and Methods: We searched multiple COVID-19 databases (WHO, CDC, LIT-COVID) for longitudinal studies globally reporting mortality and severity published before January 18th, 2021. Meta-analyses were performed using 53 studies for mortality outcome and 43 for the severity outcome. Mantel-Haenszel odds ratios were generated to describe overall effect size using random effect models. To account for between study results variations, multivariate meta-regression was performed with preselected covariates using maximum likelihood method for both the mortality and severity models. Result: Our findings showed that the use of ACEIs/ARBs did not significantly influence either mortality (OR = 1.16 95% CI 0.94-1.44, p = 0.15, I 2 = 93.2%) or severity (OR = 1.18, 95% CI 0.94-1.48, p = 0.15, I 2 = 91.1%) in comparison to not being on ACEIs/ARBs in COVID-19 positive patients. Multivariate meta-regression for the mortality model demonstrated that 36% of between study variations could be explained by differences in age, gender, and proportion of heart diseases in the study samples. Multivariate meta-regression for the severity model demonstrated that 8% of between study variations could be explained by differences in age, proportion of diabetes, heart disease and study country in the study samples. Conclusion: We found no association of mortality or severity in COVID-19 patients taking ACEIs/ARBs. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2022 Singh, Rathore, Khan, Bhurwal, Sheraton, Ghosh, Anand, Makadia, Ayesha, Mahapure, Mehra, Tekin, Kashyap and Bansal.)
Databáze:	MEDLINE
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