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

Autor: Marcello Rattazzi, Chiara Nardin, Paola Cavasin, Luca Tonon, Luca Scaldaferri, Paolo Pauletto, Ernesto De Menis, Antonio Farnia, Micaela Romagnoli, Roberto Rigoli, Ugo Grossi, Gian Luca Di Tanna, Francesco Cinetto, Carlo Agostini, Enrico Bernardi, Simone Novello, Riccardo Scarpa, Carla Felice
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
hypertensive patients
medicine.medical_specialty
ACEIs/ARBs
COVID-19 infection
SARS-COV-2
mortality
Population
Pneumonia
Viral
Angiotensin-Converting Enzyme Inhibitors
030204 cardiovascular system & hematology
Brief Communication
law.invention
03 medical and health sciences
Angiotensin Receptor Antagonists
0302 clinical medicine
law
Intensive care
Internal medicine
Risk of mortality
medicine
Internal Medicine
Humans
AcademicSubjects/MED00200
030212 general & internal medicine
education
Pandemics
Aged
Retrospective Studies
Aged
80 and over
education.field_of_study
business.industry
COVID-19
Retrospective cohort study
Odds ratio
Middle Aged
Intensive care unit
COVID-19 Drug Treatment
Blood pressure
Italy
Cohort
Hypertension
AcademicSubjects/SCI00960
Female
business
Coronavirus Infections
Zdroj: American Journal of Hypertension
ISSN: 1941-7225
0895-7061
DOI: 10.1093/ajh/hpaa096
Popis: 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.
Databáze: OpenAIRE
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