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RAAS inhibitors are not associated with mortality in COVID-19 patients: Findings from an observational multicenter study in Italy and a meta-analysis of 19 studies
Vascular pharmacology, 2020-12, Vol.135, p.106805-106805, Article 106805
2020

Details

Autor(en) / Beteiligte
Titel
RAAS inhibitors are not associated with mortality in COVID-19 patients: Findings from an observational multicenter study in Italy and a meta-analysis of 19 studies
Ist Teil von
  • Vascular pharmacology, 2020-12, Vol.135, p.106805-106805, Article 106805
Ort / Verlag
United States: Elsevier Inc
Erscheinungsjahr
2020
Link zum Volltext
Quelle
MEDLINE
Beschreibungen/Notizen
  • The hypothesis that been set forward that use of Renin Angiotensin Aldosterone System (RAAS) inhibitors is associated with COVID−19 severity. We set-up a multicenter Italian collaboration (CORIST Project, ClinicalTrials.gov ID: NCT04318418) to retrospectively investigate the relationship between RAAS inhibitors and COVID−19 in-hospital mortality. We also carried out an updated meta-analysis on the relevant studies. We analyzed 4069 unselected patients with laboratory-confirmed SARS-CoV-2 infection and hospitalized in 34 clinical centers in Italy from February 19, 2020 to May 23, 2020. The primary end-point in a time-to event analysis was in-hospital death, comparing patients who received angiotensin-converting–enzyme inhibitors (ACEI) or angiotensin-receptor blockers (ARB) with patients who did not. Articles for the meta-analysis were retrieved until July 13th, 2020 by searching in web-based libraries, and data were combined using the general variance-based method. Out of 4069 COVID−19 patients, 13.5% and 13.3% received ACE-I or ARB, respectively. Use of neither ACE-I nor ARB was associated with mortality (multivariable hazard ratio (HR) adjusted also for COVID−19 treatments: 0.96, 95% confidence interval 0.77–1.20 and HR = 0.89, 0.67–1.19 for ACE-I and ARB, respectively). Findings were similar restricting the analysis to hypertensive (N = 2057) patients (HR = 1.00, 0.78–1.26 and HR = 0.88, 0.65–1.20) or when ACE-I or ARB were considered as a single group. Results from the meta-analysis (19 studies, 29,057 COVID−19 adult patients, 9700 with hypertension) confirmed the absence of association. In this observational study and meta-analysis of the literature, ACE-I or ARB use was not associated with severity or in-hospital mortality in COVID−19 patients.
Sprache
Englisch
Identifikatoren
ISSN: 1537-1891
eISSN: 1879-3649
DOI: 10.1016/j.vph.2020.106805
Titel-ID: cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7521934
Format
–
Schlagworte
ACE-I, Aged, Aged, 80 and over, Aldosterone, Angiotensin, Angiotensin converting enzyme inhibitors, Angiotensin Receptor Antagonists - adverse effects, Angiotensin Receptor Antagonists - therapeutic use, Angiotensin receptor blockers, Angiotensin-Converting Enzyme Inhibitors - adverse effects, Angiotensin-Converting Enzyme Inhibitors - therapeutic use, Antihypertensive Agents - adverse effects, Antihypertensive Agents - therapeutic use, ARB, Confidence intervals, COVID-19, COVID-19 - diagnosis, COVID-19 - mortality, COVID-19 - therapy, COVID−19, Enzyme inhibitors, Female, Hospital Mortality, Hospitalization, Humans, Hypertension, Hypertension - drug therapy, Hypertension - epidemiology, Hypertension - physiopathology, Incidence, Italy - epidemiology, Male, Meta-analysis, Meta-Analysis as Topic, Middle Aged, Mortality, Patients, Renin, Renin-Angiotensin System - drug effects, Risk Assessment, Risk Factors, Sartans, Severe acute respiratory syndrome coronavirus 2, Severity of Illness Index

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