Safety and Efficacy of Renin-Angiotensin-Aldosterone System Inhibitors in COVID-19 Population

Autor: Mohamed Zghouzi, Ankur Panchal, Rajkumar Doshi, Hassan Bin Attique, Yasar Sattar, Abdul-Rahman M. Suleiman, Tanveer Mir, Pradeeksha Mukuntharaj, Maham Mehmood, Mamas A. Mamas, M. Chadi Alraies, Mohamad Mohamed, Omar E. Ali, Waqas Ullah, Rodrigo Bagur, Muhammad Khawar Sana, Muhammad Nadeem, Nathan Zaher, Islam Y. Elgendy
Rok vydání: 2021
Předmět:
0301 basic medicine
Male
medicine.medical_specialty
Population
Angiotensin-Converting Enzyme Inhibitors
Risk Assessment
Renin–angiotensin–aldosterone system inhibitors
Odds
Renin-Angiotensin System
03 medical and health sciences
Angiotensin Receptor Antagonists
0302 clinical medicine
Pharmacotherapy
Risk Factors
Internal medicine
Intensive care
Internal Medicine
medicine
Humans
Angiotensin receptor blocker
education
Contraindication
Aged
Randomized Controlled Trials as Topic
ACEi
education.field_of_study
business.industry
SARS-CoV-2
Contraindications
Drug
COVID-19
Odds ratio
Middle Aged
Prognosis
ARB
RAASi
Observational Studies as Topic
030104 developmental biology
Angiotensin-converting enzyme inhibitor
Host-Pathogen Interactions
Disease Progression
Observational study
Female
Original Article
Cardiology and Cardiovascular Medicine
Risk assessment
business
030217 neurology & neurosurgery
Zdroj: High Blood Pressure & Cardiovascular Prevention
ISSN: 1179-1985
Popis: Introduction The safety of renin–angiotensin–aldosterone system inhibitors (RAASi) among COVID-19 patients has been controversial since the onset of the pandemic. Methods Digital databases were queried to study the safety of RAASi in COVID-19. The primary outcome of interest was mortality. The secondary outcome was seropositivity improvement/viral clearance, clinical manifestation progression, and progression to intensive care units. A random-effect model was used to compute an unadjusted odds ratio (OR). Results A total of 49 observational studies were included in the analysis consisting of 83,269 COVID-19 patients (RAASi n = 34,691; non-RAASi n = 48,578). The mean age of the sample was 64, and 56% were males. We found that RAASi was associated with similar mortality outcomes as compared to non-RAASi groups (OR 1.07; 95% CI 0.99–1.15; p > 0.05). RAASi was associated with seropositivity improvement including negative RT-PCR or antibodies, (OR 0.96; 95% CI 0.93–0.99; p 0.05) or higher odds of worsening of clinical manifestations (OR 1.04; 95% CI 0.97–1.11; p > 0.05). Metaregression analysis did not change our outcomes for effect modifiers including age, sex, comorbidities, RAASi type, or study type on outcomes. Conclusions COVID-19 is not a contraindication to hold or discontinue RAASi as they are not associated with higher mortality or worsening symptoms. Continuation of RAASi might be associated with favorable outcomes in COVID-19, including seropositivity/viral clearance. Supplementary Information The online version contains supplementary material available at 10.1007/s40292-021-00462-w.
Databáze: OpenAIRE
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