Use of RAAS Inhibitors and Risk of Clinical Deterioration in COVID-19 : Results From an Italian Cohort of 133 Hypertensives
© American Journal of Hypertension, Ltd 2020. All rights reserved. For Permissions, please email: journals.permissionsoup.com..
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:33 |
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| Enthalten in: |
American journal of hypertension - 33(2020), 10 vom: 21. Okt., Seite 944-948 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Felice, Carla [VerfasserIn] |
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| Links: |
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| Themen: |
ACEIs/ARBs |
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| Anmerkungen: |
Date Completed 29.10.2020 Date Revised 07.12.2022 published: Print Citation Status MEDLINE |
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| doi: |
10.1093/ajh/hpaa096 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM310911486 |
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| 100 | 1 | |a Felice, Carla |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Use of RAAS Inhibitors and Risk of Clinical Deterioration in COVID-19 |b Results From an Italian Cohort of 133 Hypertensives |
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| 500 | |a Date Revised 07.12.2022 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © American Journal of Hypertension, Ltd 2020. All rights reserved. For Permissions, please email: journals.permissionsoup.com. | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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) | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a ACEIs/ARBs | |
| 650 | 4 | |a COVID-19 infection | |
| 650 | 4 | |a SARS-COV-2 | |
| 650 | 4 | |a blood pressure | |
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| 650 | 7 | |a Angiotensin Receptor Antagonists |2 NLM | |
| 650 | 7 | |a Angiotensin-Converting Enzyme Inhibitors |2 NLM | |
| 700 | 1 | |a Nardin, Chiara |e verfasserin |4 aut | |
| 700 | 1 | |a Di Tanna, Gian Luca |e verfasserin |4 aut | |
| 700 | 1 | |a Grossi, Ugo |e verfasserin |4 aut | |
| 700 | 1 | |a Bernardi, Enrico |e verfasserin |4 aut | |
| 700 | 1 | |a Scaldaferri, Luca |e verfasserin |4 aut | |
| 700 | 1 | |a Romagnoli, Micaela |e verfasserin |4 aut | |
| 700 | 1 | |a Tonon, Luca |e verfasserin |4 aut | |
| 700 | 1 | |a Cavasin, Paola |e verfasserin |4 aut | |
| 700 | 1 | |a Novello, Simone |e verfasserin |4 aut | |
| 700 | 1 | |a Scarpa, Riccardo |e verfasserin |4 aut | |
| 700 | 1 | |a Farnia, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a De Menis, Ernesto |e verfasserin |4 aut | |
| 700 | 1 | |a Rigoli, Roberto |e verfasserin |4 aut | |
| 700 | 1 | |a Cinetto, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Pauletto, Paolo |e verfasserin |4 aut | |
| 700 | 1 | |a Agostini, Carlo |e verfasserin |4 aut | |
| 700 | 1 | |a Rattazzi, Marcello |e verfasserin |4 aut | |
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