| Autor: |
Zhang, Peng, Zhu, LiHua, Cai, Jingjing, Lei, Fang, Qin, Juan-Juan, Xie, Jing, Liu, Ye-Mao, Zhao, Yan-Ci, Huang, Xuewei, Lin, Lijin, Xia, Meng, Chen, Ming-Ming, Cheng, Xu, Zhang, Xiao, Guo, Deliang, Peng, Yuanyuan, Ji, Yan-Xiao, Chen, Jing, She, Zhi-Gang, Wang, Yibin, Xu, Qingbo, Tan, Renfu, Wang, Haitao, Lin, Jun, Luo, Pengcheng, Fu, Shouzhi, Cai, Hongbin, Ye, Ping, Xiao, Bing, Mao, Weiming, Liu, Liming, Yan, Youqin, Liu, Mingyu, Chen, Manhua, Zhang, Xiao-Jing, Wang, Xinghuan, Touyz, Rhian M., Xia, Jiahong, Zhang, Bing-Hong, Huang, Xiaodong, Yuan, Yufeng, Rohit, Loomba, Liu, Peter P, Li, Hongliang |
| Jazyk: |
angličtina |
| Rok vydání: |
2020 |
| Předmět: |
|
| ISSN: |
0009-7330 |
| Popis: |
Rationale: Use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) is a major concern for clinicians treating coronavirus disease 2019 (COVID-19) in patients with hypertension. Objective: To determine the association between in-hospital use of ACEI/ARB and all-cause mortality in COVID-19 patients with hypertension. Methods and Results: This retrospective, multi-center study included 1128 adult patients with hypertension diagnosed with COVID-19, including 188 taking ACEI/ARB (ACEI/ARB group; median age 64 [IQR 55-68] years; 53.2% men) and 940 without using ACEI/ARB (non-ACEI/ARB group; median age 64 [IQR 57-69]; 53.5% men), who were admitted to nine hospitals in Hubei Province, China from December 31, 2019 to February 20, 2020. Unadjusted mortality rate was lower in the ACEI/ARB group versus the non-ACEI/ARB group (3.7% vs. 9.8%; P = 0.01). In mixed-effect Cox model treating site as a random effect, after adjusting for age, gender, comorbidities, and in-hospital medications, the detected risk for all-cause mortality was lower in the ACEI/ARB group versus the non-ACEI/ARB group (adjusted HR, 0.42; 95% CI, 0.19-0.92; P =0.03). In a propensity score-matched analysis followed by adjusting imbalanced variables in mixed-effect Cox model, the results consistently demonstrated lower risk of COVID-19 mortality in patients who received ACEI/ARB versus those who did not receive ACEI/ARB (adjusted HR, 0.37; 95% CI, 0.15-0.89; P = 0.03). Further subgroup propensity score-matched analysis indicated that, compared to use of other antihypertensive drugs, ACEI/ARB was also associated with decreased mortality (adjusted HR, 0.30; 95%CI, 0.12-0.70; P = 0.01) in COVID-19 patients with hypertension. Conclusions: Among hospitalized COVID-19 patients with hypertension, inpatient use of ACEI/ARB was associated with lower risk of all-cause mortality compared with ACEI/ARB non-users. While study interpretation needs to consider the potential for residual confounders, it is unlikely that in-hospital use of ACEI/ARB was associated with an increased mortality risk. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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