Mortality and Severity in COVID-19 Patients on ACEIs and ARBs-A Systematic Review, Meta-Analysis, and Meta-Regression Analysis
Copyright © 2022 Singh, Rathore, Khan, Bhurwal, Sheraton, Ghosh, Anand, Makadia, Ayesha, Mahapure, Mehra, Tekin, Kashyap and Bansal..
Purpose: The primary objective of this systematic review is to assess association of mortality in COVID-19 patients on Angiotensin-converting-enzyme inhibitors (ACEIs) and Angiotensin-II receptor blockers (ARBs). A secondary objective is to assess associations with higher severity of the disease in COVID-19 patients. Materials and Methods: We searched multiple COVID-19 databases (WHO, CDC, LIT-COVID) for longitudinal studies globally reporting mortality and severity published before January 18th, 2021. Meta-analyses were performed using 53 studies for mortality outcome and 43 for the severity outcome. Mantel-Haenszel odds ratios were generated to describe overall effect size using random effect models. To account for between study results variations, multivariate meta-regression was performed with preselected covariates using maximum likelihood method for both the mortality and severity models. Result: Our findings showed that the use of ACEIs/ARBs did not significantly influence either mortality (OR = 1.16 95% CI 0.94-1.44, p = 0.15, I 2 = 93.2%) or severity (OR = 1.18, 95% CI 0.94-1.48, p = 0.15, I 2 = 91.1%) in comparison to not being on ACEIs/ARBs in COVID-19 positive patients. Multivariate meta-regression for the mortality model demonstrated that 36% of between study variations could be explained by differences in age, gender, and proportion of heart diseases in the study samples. Multivariate meta-regression for the severity model demonstrated that 8% of between study variations could be explained by differences in age, proportion of diabetes, heart disease and study country in the study samples. Conclusion: We found no association of mortality or severity in COVID-19 patients taking ACEIs/ARBs.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:8 |
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| Enthalten in: |
Frontiers in medicine - 8(2021) vom: 18., Seite 703661 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Singh, Romil [VerfasserIn] |
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| Links: |
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| Themen: |
ACEI |
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| Anmerkungen: |
Date Revised 03.11.2023 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.3389/fmed.2021.703661 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM336176236 |
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| 520 | |a Purpose: The primary objective of this systematic review is to assess association of mortality in COVID-19 patients on Angiotensin-converting-enzyme inhibitors (ACEIs) and Angiotensin-II receptor blockers (ARBs). A secondary objective is to assess associations with higher severity of the disease in COVID-19 patients. Materials and Methods: We searched multiple COVID-19 databases (WHO, CDC, LIT-COVID) for longitudinal studies globally reporting mortality and severity published before January 18th, 2021. Meta-analyses were performed using 53 studies for mortality outcome and 43 for the severity outcome. Mantel-Haenszel odds ratios were generated to describe overall effect size using random effect models. To account for between study results variations, multivariate meta-regression was performed with preselected covariates using maximum likelihood method for both the mortality and severity models. Result: Our findings showed that the use of ACEIs/ARBs did not significantly influence either mortality (OR = 1.16 95% CI 0.94-1.44, p = 0.15, I 2 = 93.2%) or severity (OR = 1.18, 95% CI 0.94-1.48, p = 0.15, I 2 = 91.1%) in comparison to not being on ACEIs/ARBs in COVID-19 positive patients. Multivariate meta-regression for the mortality model demonstrated that 36% of between study variations could be explained by differences in age, gender, and proportion of heart diseases in the study samples. Multivariate meta-regression for the severity model demonstrated that 8% of between study variations could be explained by differences in age, proportion of diabetes, heart disease and study country in the study samples. Conclusion: We found no association of mortality or severity in COVID-19 patients taking ACEIs/ARBs | ||
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a ACEI | |
| 650 | 4 | |a ARB | |
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| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a meta-analysis | |
| 650 | 4 | |a meta-regression | |
| 650 | 4 | |a mortality | |
| 650 | 4 | |a severity | |
| 700 | 1 | |a Rathore, Sawai Singh |e verfasserin |4 aut | |
| 700 | 1 | |a Khan, Hira |e verfasserin |4 aut | |
| 700 | 1 | |a Bhurwal, Abhishek |e verfasserin |4 aut | |
| 700 | 1 | |a Sheraton, Mack |e verfasserin |4 aut | |
| 700 | 1 | |a Ghosh, Prithwish |e verfasserin |4 aut | |
| 700 | 1 | |a Anand, Sohini |e verfasserin |4 aut | |
| 700 | 1 | |a Makadia, Janaki |e verfasserin |4 aut | |
| 700 | 1 | |a Ayesha, Fnu |e verfasserin |4 aut | |
| 700 | 1 | |a Mahapure, Kiran S |e verfasserin |4 aut | |
| 700 | 1 | |a Mehra, Ishita |e verfasserin |4 aut | |
| 700 | 1 | |a Tekin, Aysun |e verfasserin |4 aut | |
| 700 | 1 | |a Kashyap, Rahul |e verfasserin |4 aut | |
| 700 | 1 | |a Bansal, Vikas |e verfasserin |4 aut | |
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