Renin-Angiotensin-Aldosterone System Inhibitors and COVID-19 Infection or Hospitalization : A Cohort Study
© American Journal of Hypertension, Ltd 2020. All rights reserved. For Permissions, please email: journals.permissionsoup.com..
BACKGROUND: Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) may increase the risk of coronavirus disease 2019 (COVID-19) infection or affect disease severity. Prior studies have not examined risks by medication dose.
METHODS: This retrospective cohort study included people aged ≥18 years enrolled in a US integrated healthcare system for at least 4 months as of 2/29/2020. Current ACEI and ARB use was identified from pharmacy data, and the estimated daily dose was calculated and standardized across medications. COVID-19 infections and hospitalizations were identified through 6/14/2020 from laboratory and hospitalization data. We used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for race/ethnicity, obesity, and other covariates.
RESULTS: Among 322,044 individuals, 826 developed COVID-19 infection. Among people using ACEI/ARBs, 204/56,105 developed COVID-19 (3.6 per 1,000 individuals) compared with 622/265,939 without ACEI/ARB use (2.3 per 1,000), yielding an adjusted OR of 0.91 (95% CI 0.74-1.12). For use of <1 defined daily dose (DDD) vs. nonuse, the adjusted OR for infection was 0.92 (95% CI 0.66-1.28); for 1 to <2 DDDs, 0.89 (95% CI 0.66-1.19); and for ≥2 DDDs, 0.92 (95% CI 0.72-1.18). The OR was similar for ACEIs and ARBs and in subgroups by age and sex. 26% of people with COVID-19 infection were hospitalized; the adjusted OR for hospitalization in relation to ACEI/ARB use was 0.98 (95% CI 0.63-1.54), and there was no association with dose.
CONCLUSIONS: These findings support current recommendations that individuals on these medications continue their use.
| Errataetall: | |
|---|---|
| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:34 |
|---|---|
| Enthalten in: |
American journal of hypertension - 34(2021), 4 vom: 20. Apr., Seite 339-347 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Dublin, Sascha [VerfasserIn] |
|---|
| Links: |
|---|
| Anmerkungen: |
Date Completed 05.05.2021 Date Revised 11.10.2022 published: Print UpdateOf: medRxiv. 2020 Jul 07;:. - PMID 32676610 Citation Status MEDLINE |
|---|
| doi: |
10.1093/ajh/hpaa168 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM31617839X |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM31617839X | ||
| 003 | DE-627 | ||
| 005 | 20231225160523.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1093/ajh/hpaa168 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1053.xml |
| 035 | |a (DE-627)NLM31617839X | ||
| 035 | |a (NLM)33048112 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Dublin, Sascha |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Renin-Angiotensin-Aldosterone System Inhibitors and COVID-19 Infection or Hospitalization |b A Cohort Study |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 05.05.2021 | ||
| 500 | |a Date Revised 11.10.2022 | ||
| 500 | |a published: Print | ||
| 500 | |a UpdateOf: medRxiv. 2020 Jul 07;:. - PMID 32676610 | ||
| 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: Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) may increase the risk of coronavirus disease 2019 (COVID-19) infection or affect disease severity. Prior studies have not examined risks by medication dose | ||
| 520 | |a METHODS: This retrospective cohort study included people aged ≥18 years enrolled in a US integrated healthcare system for at least 4 months as of 2/29/2020. Current ACEI and ARB use was identified from pharmacy data, and the estimated daily dose was calculated and standardized across medications. COVID-19 infections and hospitalizations were identified through 6/14/2020 from laboratory and hospitalization data. We used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for race/ethnicity, obesity, and other covariates | ||
| 520 | |a RESULTS: Among 322,044 individuals, 826 developed COVID-19 infection. Among people using ACEI/ARBs, 204/56,105 developed COVID-19 (3.6 per 1,000 individuals) compared with 622/265,939 without ACEI/ARB use (2.3 per 1,000), yielding an adjusted OR of 0.91 (95% CI 0.74-1.12). For use of <1 defined daily dose (DDD) vs. nonuse, the adjusted OR for infection was 0.92 (95% CI 0.66-1.28); for 1 to <2 DDDs, 0.89 (95% CI 0.66-1.19); and for ≥2 DDDs, 0.92 (95% CI 0.72-1.18). The OR was similar for ACEIs and ARBs and in subgroups by age and sex. 26% of people with COVID-19 infection were hospitalized; the adjusted OR for hospitalization in relation to ACEI/ARB use was 0.98 (95% CI 0.63-1.54), and there was no association with dose | ||
| 520 | |a CONCLUSIONS: These findings support current recommendations that individuals on these medications continue their use | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a angiotensin receptor blocker | |
| 650 | 4 | |a angiotensin-converting enzyme inhibitor | |
| 650 | 4 | |a blood pressure | |
| 650 | 4 | |a coronavirus | |
| 650 | 4 | |a hospitalization | |
| 650 | 4 | |a hypertension | |
| 650 | 4 | |a infection | |
| 650 | 7 | |a Angiotensin Receptor Antagonists |2 NLM | |
| 650 | 7 | |a Angiotensin-Converting Enzyme Inhibitors |2 NLM | |
| 700 | 1 | |a Walker, Rod L |e verfasserin |4 aut | |
| 700 | 1 | |a Floyd, James S |e verfasserin |4 aut | |
| 700 | 1 | |a Shortreed, Susan M |e verfasserin |4 aut | |
| 700 | 1 | |a Fuller, Sharon |e verfasserin |4 aut | |
| 700 | 1 | |a Albertson-Junkans, Ladia |e verfasserin |4 aut | |
| 700 | 1 | |a Harrington, Laura B |e verfasserin |4 aut | |
| 700 | 1 | |a Greenwood-Hickman, Mikael Anne |e verfasserin |4 aut | |
| 700 | 1 | |a Green, Beverly B |e verfasserin |4 aut | |
| 700 | 1 | |a Psaty, Bruce M |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t American journal of hypertension |d 1988 |g 34(2021), 4 vom: 20. Apr., Seite 339-347 |w (DE-627)NLM012611670 |x 1941-7225 |7 nnns |
| 773 | 1 | 8 | |g volume:34 |g year:2021 |g number:4 |g day:20 |g month:04 |g pages:339-347 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1093/ajh/hpaa168 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 34 |j 2021 |e 4 |b 20 |c 04 |h 339-347 | ||