Use of Renin-Angiotensin-Aldosterone System Inhibitors and Severe COVID-19 Outcomes in Patients with Hypertension: A Nationwide Cohort Study
Autor: | Jae Hyun Bae, Nam Hoon Kim, Sun Kyu Choi, Sin Gon Kim, Juneyoung Lee |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
Male
medicine.medical_specialty hypertension Endocrinology Diabetes and Metabolism medicine.medical_treatment 030209 endocrinology & metabolism renin-angiotensin system 030204 cardiovascular system & hematology respiration artificial Diseases of the endocrine glands. Clinical endocrinology law.invention Cohort Studies 03 medical and health sciences 0302 clinical medicine law Risk Factors Diabetes mellitus Internal medicine Republic of Korea Extracorporeal membrane oxygenation medicine angiotensin receptor antagonists Humans Renal replacement therapy Antihypertensive Agents Aged Mechanical ventilation business.industry Odds ratio Middle Aged medicine.disease RC648-665 Intensive care unit Confidence interval Hospitalization angiotensin-converting enzyme inhibitors Intensive Care Units covid-19 Original Article Female business Cohort study |
Zdroj: | Diabetes & Metabolism Journal, Vol 45, Iss 3, Pp 430-438 (2021) Diabetes & Metabolism Journal |
ISSN: | 2233-6087 2233-6079 |
Popis: | Background Angiotensin-converting enzyme 2 facilitates the entry of severe acute respiratory syndrome coronavirus 2 into the human body. We investigated the association of renin-angiotensin-aldosterone system (RAAS) inhibitor use with severe coronavirus disease 2019 (COVID-19) outcomes in hypertensive patients. Methods We identified hypertensive patients with confirmed COVID-19 from the Korean Health Insurance Review and Assessment Service from inception to May 15, 2020. The primary outcome was the composite of intensive care unit (ICU) admission, invasive mechanical ventilation (IMV), continuous renal replacement therapy (CRRT), extracorporeal membrane oxygenation (ECMO), and death from COVID-19. The individual components were evaluated as secondary outcomes. Results Of 1,374 hypertensive patients with COVID-19, 1,076 (78.3%) and 298 (21.7%) were users and never-users of RAAS inhibitors, respectively. The RAAS inhibitor users were not associated with the risk of the primary outcome (adjusted odds ratio [aOR], 0.72; 95% confidence interval [CI], 0.46 to 1.10). The risk of ICU admission was significantly lower in the users than the never-users (aOR, 0.44; 95% CI, 0.24 to 0.84). The RAAS inhibitors were beneficial only in ICU admissions that did not require IMV (aOR, 0.28; 95% CI, 0.14 to 0.58). The risk of death from COVID-19 was comparable between the groups (aOR, 1.09; 95% CI, 0.64 to 1.85). We could not evaluate the risks of CRRT and ECMO owing to the small number of events. Conclusion RAAS inhibitor use was not associated with the composite of severe outcomes in the hypertensive patients with COVID-19 but significantly lowered the risk of ICU admission, particularly in patients who did not require IMV. |
Databáze: | OpenAIRE |
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