Outcomes of COVID-19 Hospitalized Patients Previously Treated with Renin-Angiotensin System Inhibitors
| Autor: | Valérie B. Schini-Kerth, Amer Hamadé, Dominique Stephan, Ferhat Meziani, A.-S. Frantz, François Severac, W. Younes, M. Heitz, Jonathan Tousch, Patrick Ohlmann, Lucas Jambert, Emmanuel Andrès, Hamid Merdji, Corina Mirea, E.-M. Cordeanu, Pascal Bilbault, H. Lambach |
|---|---|
| Přispěvatelé: | univOAK, Archive ouverte, CHU Strasbourg, Centre Hospitalier Emile Muller [Mulhouse] (CH E.Muller Mulhouse), Groupe Hospitalier de Territoire Haute Alsace (GHTHA), Les Hôpitaux Universitaires de Strasbourg (HUS), CH Colmar, Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE) |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment viruses Population lcsh:Medicine 030204 cardiovascular system & hematology Article 03 medical and health sciences 0302 clinical medicine angiotensin-converting enzyme Internal medicine Medicine Intubation education propensity score 030304 developmental biology Mechanical ventilation 0303 health sciences education.field_of_study business.industry SARS-CoV-2 lcsh:R Hazard ratio virus diseases COVID-19 General Medicine medicine.disease Confidence interval angiotensin II receptor blocker Pneumonia [INFO.INFO-TI] Computer Science [cs]/Image Processing [eess.IV] [INFO.INFO-TI]Computer Science [cs]/Image Processing [eess.IV] Propensity score matching Cohort business renin–angiotensin system inhibitor |
| Zdroj: | Journal of Clinical Medicine Volume 9 Issue 11 Journal of Clinical Medicine, MDPI, 2020, 9 (11), ⟨10.3390/jcm9113472⟩ Journal of Clinical Medicine, 2020, 9 (11), ⟨10.3390/jcm9113472⟩ Journal of Clinical Medicine, Vol 9, Iss 3472, p 3472 (2020) |
| ISSN: | 2077-0383 |
| DOI: | 10.3390/jcm9113472 |
| Popis: | (1) Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) penetrates respiratory epithelium through angiotensin-converting enzyme-2 binding, raising concerns about the potentially harmful effects of renin&ndash angiotensin system inhibitors (RASi) on Human Coronavirus Disease 2019 (COVID-19) evolution. This study aimed to provide insight into the impact of RASi on SARS-CoV-2 outcomes in patients hospitalized for COVID-19. (2) Methods: This was a retrospective analysis of hospitalized adult patients with SARS-CoV-2 infection admitted to a university hospital in France. The observation period ended at hospital discharge. (3) Results: During the study period, 943 COVID-19 patients were admitted to our institution, of whom 772 were included in this analysis. Among them, 431 (55.8%) had previously known hypertension. The median age was 68 (56&ndash 79) years. Overall, 220 (28.5%) patients were placed under mechanical ventilation and 173 (22.4%) died. According to previous exposure to RASi, we defined two groups, namely, &ldquo RASi&rdquo (n = 282) and &ldquo RASi-free&rdquo (n = 490). Severe pneumonia (defined as leading to death and/or requiring intubation, high-flow nasal oxygen, noninvasive ventilation, and/or oxygen flow at a rate of &ge 5 L/min) and death occurred more frequently in RASi-treated patients (64% versus 53% and 29% versus 19%, respectively). However, in a propensity score-matched cohort derived from the overall population, neither death (hazard ratio (HR) 0.93 (95% confidence interval (CI) 0.57&ndash 1.50), p = 0.76) nor severe pneumonia (HR 1.03 (95%CI 0.73&ndash 1.44), p = 0.85) were associated with RASi therapy. (4) Conclusion: Our study showed no correlation between previous RASi treatment and death or severe COVID-19 pneumonia after adjustment for confounders. |
| Databáze: | OpenAIRE |
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