Effects of Angiotensin Receptor Blockers (ARBs) on In-Hospital Outcomes of Patients With Hypertension and Confirmed or Clinically Suspected COVID-19
© American Journal of Hypertension, Ltd 2020. All rights reserved. For Permissions, please email: journals.permissionsoup.com..
BACKGROUND: There is an ongoing controversy about harms and benefits of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) in hypertensive patients with coronavirus disease 2019 (COVID-19). Given the unresolved debate, we investigated the association of ARBs with in-hospital outcomes of these patients.
METHODS: In this retrospective observational study, we studied patients with COVID-19 who referred to Sina Hospital in Tehran, Iran, from 20 February to 29 May 2020. Patients with either positive real-time reverse-transcriptase polymerase-chain-reaction test of swab specimens, or high clinical suspicion according to the World Health Organization's interim guidance were included. We followed-up patients for incurring death, severe COVID-19, and in-hospital complications.
RESULTS: We evaluated 681 patients with COVID-19 of whom 37 patients were excluded due to incomplete medical records and 8 patients who used ACEIs which left 636 patients in the analysis. In this cohort, 108 (17.0%) patients expired and 407 (64.0%) patients incurred severe COVID-19. Of 254 (39.9%) patients with hypertension, 122 (48.0%) patients were receiving an ARB. After adjustment for possible confounders, we found no independent association between taking ARBs and in-hospital outcomes except for acute kidney injury (AKI), in patients with confirmed or clinically suspected COVID-19, either hypertensive or not-hypertensive. We found that discontinuation of ARBs during hospitalization was associated with a greater risk of mortality, invasive ventilation, and AKI (all P ˂ 0.002).
CONCLUSIONS: We found that taking ARBs by patients with hypertension and confirmed or clinically suspected COVID-19 is not associated with poorer in-hospital outcomes after adjustment for possible confounders.
| 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), 12 vom: 31. Dez., Seite 1102-1111 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Soleimani, Abbas [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 27.01.2021 Date Revised 27.01.2021 published: Print Citation Status MEDLINE |
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| doi: |
10.1093/ajh/hpaa149 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM314927301 |
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| 500 | |a Date Revised 27.01.2021 | ||
| 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: There is an ongoing controversy about harms and benefits of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) in hypertensive patients with coronavirus disease 2019 (COVID-19). Given the unresolved debate, we investigated the association of ARBs with in-hospital outcomes of these patients | ||
| 520 | |a METHODS: In this retrospective observational study, we studied patients with COVID-19 who referred to Sina Hospital in Tehran, Iran, from 20 February to 29 May 2020. Patients with either positive real-time reverse-transcriptase polymerase-chain-reaction test of swab specimens, or high clinical suspicion according to the World Health Organization's interim guidance were included. We followed-up patients for incurring death, severe COVID-19, and in-hospital complications | ||
| 520 | |a RESULTS: We evaluated 681 patients with COVID-19 of whom 37 patients were excluded due to incomplete medical records and 8 patients who used ACEIs which left 636 patients in the analysis. In this cohort, 108 (17.0%) patients expired and 407 (64.0%) patients incurred severe COVID-19. Of 254 (39.9%) patients with hypertension, 122 (48.0%) patients were receiving an ARB. After adjustment for possible confounders, we found no independent association between taking ARBs and in-hospital outcomes except for acute kidney injury (AKI), in patients with confirmed or clinically suspected COVID-19, either hypertensive or not-hypertensive. We found that discontinuation of ARBs during hospitalization was associated with a greater risk of mortality, invasive ventilation, and AKI (all P ˂ 0.002) | ||
| 520 | |a CONCLUSIONS: We found that taking ARBs by patients with hypertension and confirmed or clinically suspected COVID-19 is not associated with poorer in-hospital outcomes after adjustment for possible confounders | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a SARS-CoV-2 | |
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| 650 | 7 | |a Angiotensin Receptor Antagonists |2 NLM | |
| 650 | 7 | |a Antihypertensive Agents |2 NLM | |
| 700 | 1 | |a Kazemian, Sina |e verfasserin |4 aut | |
| 700 | 1 | |a Karbalai Saleh, Shahrokh |e verfasserin |4 aut | |
| 700 | 1 | |a Aminorroaya, Arya |e verfasserin |4 aut | |
| 700 | 1 | |a Shajari, Zahra |e verfasserin |4 aut | |
| 700 | 1 | |a Hadadi, Azar |e verfasserin |4 aut | |
| 700 | 1 | |a Talebpour, Mohammad |e verfasserin |4 aut | |
| 700 | 1 | |a Sadeghian, Hakimeh |e verfasserin |4 aut | |
| 700 | 1 | |a Payandemehr, Pooya |e verfasserin |4 aut | |
| 700 | 1 | |a Sotoodehnia, Mehran |e verfasserin |4 aut | |
| 700 | 1 | |a Bahreini, Maryam |e verfasserin |4 aut | |
| 700 | 1 | |a Najmeddin, Farhad |e verfasserin |4 aut | |
| 700 | 1 | |a Heidarzadeh, Ali |e verfasserin |4 aut | |
| 700 | 1 | |a Zivari, Ensieh |e verfasserin |4 aut | |
| 700 | 1 | |a Ashraf, Haleh |e verfasserin |4 aut | |
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