Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers Withdrawal Is Associated with Higher Mortality in Hospitalized Patients with COVID-19
Our main aim was to describe the effect on the severity of ACEI (angiotensin-converting enzyme inhibitor) and ARB (angiotensin II receptor blocker) during COVID-19 hospitalization. A retrospective, observational, multicenter study evaluating hospitalized patients with COVID-19 treated with ACEI/ARB. The primary endpoint was the incidence of the composite outcome of prognosis (IMV (invasive mechanical ventilation), NIMV (non-invasive mechanical ventilation), ICU admission (intensive care unit), and/or all-cause mortality). We evaluated both outcomes in patients whose treatment with ACEI/ARB was continued or withdrawn. Between February and June 2020, 11,205 patients were included, mean age 67 years (SD = 16.3) and 43.1% female; 2162 patients received ACEI/ARB treatment. ACEI/ARB treatment showed lower all-cause mortality (p < 0.0001). Hypertensive patients in the ACEI/ARB group had better results in IMV, ICU admission, and the composite outcome of prognosis (p < 0.0001 for all). No differences were found in the incidence of major adverse cardiovascular events. Patients previously treated with ACEI/ARB continuing treatment during hospitalization had a lower incidence of the composite outcome of prognosis than those whose treatment was withdrawn (RR 0.67, 95%CI 0.63-0.76). ARB was associated with better survival than ACEI (HR 0.77, 95%CI 0.62-0.96). ACEI/ARB treatment during COVID-19 hospitalization was associated with protection on mortality. The benefits were greater in hypertensive, those who continued treatment, and those taking ARB.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:10 |
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| Enthalten in: |
Journal of clinical medicine - 10(2021), 12 vom: 15. Juni |
| Sprache: |
Englisch |
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| Links: |
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| Themen: |
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| Anmerkungen: |
Date Revised 05.07.2021 published: Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.3390/jcm10122642 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM327507322 |
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| 245 | 1 | 0 | |a Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers Withdrawal Is Associated with Higher Mortality in Hospitalized Patients with COVID-19 |
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| 500 | |a published: Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a Our main aim was to describe the effect on the severity of ACEI (angiotensin-converting enzyme inhibitor) and ARB (angiotensin II receptor blocker) during COVID-19 hospitalization. A retrospective, observational, multicenter study evaluating hospitalized patients with COVID-19 treated with ACEI/ARB. The primary endpoint was the incidence of the composite outcome of prognosis (IMV (invasive mechanical ventilation), NIMV (non-invasive mechanical ventilation), ICU admission (intensive care unit), and/or all-cause mortality). We evaluated both outcomes in patients whose treatment with ACEI/ARB was continued or withdrawn. Between February and June 2020, 11,205 patients were included, mean age 67 years (SD = 16.3) and 43.1% female; 2162 patients received ACEI/ARB treatment. ACEI/ARB treatment showed lower all-cause mortality (p < 0.0001). Hypertensive patients in the ACEI/ARB group had better results in IMV, ICU admission, and the composite outcome of prognosis (p < 0.0001 for all). No differences were found in the incidence of major adverse cardiovascular events. Patients previously treated with ACEI/ARB continuing treatment during hospitalization had a lower incidence of the composite outcome of prognosis than those whose treatment was withdrawn (RR 0.67, 95%CI 0.63-0.76). ARB was associated with better survival than ACEI (HR 0.77, 95%CI 0.62-0.96). ACEI/ARB treatment during COVID-19 hospitalization was associated with protection on mortality. The benefits were greater in hypertensive, those who continued treatment, and those taking ARB | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a ACEI | |
| 650 | 4 | |a ARB | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a MACE | |
| 650 | 4 | |a prognosis | |
| 700 | 1 | |a Sánchez Purificación, Aquilino |e verfasserin |4 aut | |
| 700 | 1 | |a Torres Peña, José David |e verfasserin |4 aut | |
| 700 | 1 | |a Sánchez Moreno, Beatriz |e verfasserin |4 aut | |
| 700 | 1 | |a Arnalich, Francisco |e verfasserin |4 aut | |
| 700 | 1 | |a García Blanco, María José |e verfasserin |4 aut | |
| 700 | 1 | |a López Miranda, José |e verfasserin |4 aut | |
| 700 | 1 | |a Romero-Cabrera, Juan Luis |e verfasserin |4 aut | |
| 700 | 1 | |a Herrero Gil, Carmen Rosario |e verfasserin |4 aut | |
| 700 | 1 | |a Bascunana, José |e verfasserin |4 aut | |
| 700 | 1 | |a Rubio-Rivas, Manuel |e verfasserin |4 aut | |
| 700 | 1 | |a Pintos Otero, Sara |e verfasserin |4 aut | |
| 700 | 1 | |a Martínez Sempere, Verónica |e verfasserin |4 aut | |
| 700 | 1 | |a Ballano Rodríguez-Solís, Jesús |e verfasserin |4 aut | |
| 700 | 1 | |a Gil Sánchez, Ricardo |e verfasserin |4 aut | |
| 700 | 1 | |a Luque Del Pino, Jairo |e verfasserin |4 aut | |
| 700 | 1 | |a González Noya, Amara |e verfasserin |4 aut | |
| 700 | 1 | |a Navas-Alcántara, María Sierra |e verfasserin |4 aut | |
| 700 | 1 | |a Cortés Rodríguez, Begoña |e verfasserin |4 aut | |
| 700 | 1 | |a Alcalá, José Nicolás |e verfasserin |4 aut | |
| 700 | 1 | |a Suárez-Lombraña, Ana |e verfasserin |4 aut | |
| 700 | 1 | |a Andrés Soler, Jorge |e verfasserin |4 aut | |
| 700 | 1 | |a Gómez-Huelgas, Ricardo |e verfasserin |4 aut | |
| 700 | 1 | |a Casas-Rojo, José Manuel |e verfasserin |4 aut | |
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