The Association between Chronic Use of Renin–Angiotensin-Aldosterone System Blockers and in-Hospital Adverse Events among COVID-19 Patients with Hypertension
| Autor: | Mustafa Altınay, Safiye Nur Ozcan, Ozgur Selim Ser, Kadriye Orta Kilickesmez, Hakan Kilci, Süleyman Sezai Yıldız, Yildiz Verdi, Betul Balaban Kocas, Gokhan Cetinkal |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Multivariate analysis hypertension Coronavirus disease 2019 (COVID-19) business.industry medicine.medical_treatment COVID-19 General Medicine Logistic regression RAAS blockers Intensive care unit mortality Procalcitonin law.invention law Internal medicine Renin–angiotensin system medicine Intubation cardiovascular diseases adverse clinical outcomes business Adverse effect Original Research |
| Zdroj: | The Medical Bulletin of Sisli Etfal Hospital |
| ISSN: | 1308-5123 1302-7123 |
| Popis: | Objectives The effects of chronic renin-angiotensin-aldosterone system (RAAS) blockers usage on adverse outcomes and disease severity remain uncertain in COVID-19 patients with hypertension. In this study, we aimed to determine the relationship between chronic use of RAAS inhibitors and in-hospital adverse events among hypertensive patients hospitalized with COVID-19. Methods In this retrospective single-center study, we enrolled 349 consecutive hypertensive patients diagnosed with COVID-19 infection. All patients were chronically on angiotensin-converting enzyme inhibitors (ACEI)/ angiotensin II receptor blockers (ARB) or other antihypertensive therapies before hospital admission. Adverse clinical events were defined as in-hospital mortality, admission to intensive care unit, need for high-flow oxygen and intubation. Results Patients were categorized into two groups according to the type of antihypertensive therapy. (ACEI/ARBs users, N=201; ACEI/ARB nonusers, N=148) There was no statistically significant difference between ACEI/ARBs users and ACEI/ARBs nonusers concerning adverse clinical events, such as in-hospital mortality (29 (14.4%) vs. 20 (13.5%), p=0.81), ICU admission (45(22.4%) vs. 27 (18.2%), p=0.34), need for high-flow oxygen (97 (48.3%) vs. 68 (45.9%), p=0.67) and need for intubation (32(15.9%) vs. 23(15.5%), p=0.92), respectively. Also, the severity of infection did not differ among groups. The logistic regression multivariate analysis showed that age, neutrophil-lymphocyte ratio, procalcitonin and ferritin levels were independent predictors of in-hospital mortality. Conclusion Our results suggest that chronic use of ACEI/ARBs did not increase in-hospital adverse outcomes of hypertensive patients hospitalized with COVID-19. Although the recent data are contradictory, chronic ACEI/ARB therapy is not recommended to be discontinued in hypertensive patients during their hospitalization for COVID-19. |
| Databáze: | OpenAIRE |
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