Outcomes of hospitalized patients with SARS-CoV-2 infection previously treated with renin-angiotensin system inhibitors

Autor: A. Delatte, Ferhat Meziani, J. Tousch, W. Younes, H. Lambach, L. Jambert, Pascal Bilbault, D. Stephan, A.-S. Frantz, Corina Mirea, E.-M. Cordeanu, Emmanuel Andrès, M. Heitz, B. Woehl, Philippe Ohlmann
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Archives of Cardiovascular Diseases. Supplements
Archives of Cardiovascular Diseases Supplements
ISSN: 1878-6502
1878-6480
Popis: Background Renin angiotensin system inhibitors (RASi) are largely prescribed in hypertensive patients. As severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) penetrates respiratory epithelium through angiotensin converting enzyme 2 (ACE2) binding, the association between RASi and poorer outcomes has been questioned. Purpose This study aimed to provide insight on the impact of RASi on SARS-CoV-2 outcomes in a population of patients hospitalized for COVID-19. Methods This is a retrospective analysis of consecutively hospitalized adult patients with SARS-CoV-2 infection (positive rtPCR) admitted to the University Hospital of Strasbourg from the 25th Feb, 2020 to the 1st Apr, 2020. Patients hospitalized for less than 24 h were excluded and the observation period ended at hospital discharge. Results During the study period, 943 COVID-19 patients were hospitalized in our institution, of whom 772 were included in this analysis. Among them, 431 patients had previously known hypertension. The median age was 68 (56–79). The cohort was divided into two subgroups based on RASi treatment on admission: “RASi” (n = 282) and “RASi-free” (n = 490). Both groups had similar clinical presentations and equivalent recourse to endotracheal intubation, high flow nasal oxygen (HFNO) or non-invasive ventilation (NIV). Overall, 220 patients were placed under mechanical ventilation of whom 30% died. Severe pneumonia (defined as either leading to death, and/or requiring intubation, HFNO, NIV and/or requiring an oxygen rate flow ≥ 5l/min) and death occurred more frequently in RASi treated patients (63% vs. 53% and respectively 27.3% versus 18.2%). In a multivariate logistic-regression model, neither severe pneumonia nor death were associated with RASi treatment. Conclusion Our study showed no correlation between RASi treatment and death or severe COVID-19 pneumonia.
Databáze: OpenAIRE
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