1. Positive association of angiotensin II receptor blockers, not angiotensin-converting enzyme inhibitors, with an increased vulnerability to SARS-CoV-2 infection in patients hospitalized for suspected COVID-19 pneumonia.
- Author
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Georges JL, Gilles F, Cochet H, Bertrand A, De Tournemire M, Monguillon V, Pasqualini M, Prevot A, Roger G, Saba J, Soltani J, Koukabi-Fradelizi M, Beressi JP, Laureana C, Prost JF, and Livarek B
- Subjects
- Adult, Aged, Aged, 80 and over, Angiotensin II Type 2 Receptor Blockers therapeutic use, COVID-19 diagnosis, Female, Humans, Hypertension drug therapy, Male, Middle Aged, Pneumonia diagnosis, Retrospective Studies, Risk Factors, Angiotensin II Type 2 Receptor Blockers adverse effects, Angiotensin-Converting Enzyme Inhibitors adverse effects, COVID-19 complications, Pneumonia complications
- Abstract
Background: Angiotensin-converting enzyme 2 is the receptor that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) uses for entry into lung cells. Because ACE-2 may be modulated by angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs), there is concern that patients treated with ACEIs and ARBs are at higher risk of coronavirus disease 2019 (COVID-19) pneumonia., Aim: This study sought to analyze the association of COVID-19 pneumonia with previous treatment with ACEIs and ARBs., Materials and Methods: We retrospectively reviewed 684 consecutive patients hospitalized for suspected COVID-19 pneumonia and tested by polymerase chain reaction assay. Patients were split into two groups, according to whether (group 1, n = 484) or not (group 2, n = 250) COVID-19 was confirmed. Multivariable adjusted comparisons included a propensity score analysis., Results: The mean age was 63.6 ± 18.7 years, and 302 patients (44%) were female. Hypertension was present in 42.6% and 38.4% of patients in groups 1 and 2, respectively (P = 0.28). Treatment with ARBs was more frequent in group 1 than group 2 (20.7% vs. 12.0%, respectively; odds ratio [OR] 1.92, 95% confidence interval [CI] 1.23-2.98; P = 0.004). No difference was found for treatment with ACEIs (12.7% vs. 15.7%, respectively; OR 0.81, 95% CI 0.52-1.26; P = 0.35). Propensity score-matched multivariable logistic regression confirmed a significant association between COVID-19 and previous treatment with ARBs (adjusted OR 2.36, 95% CI 1.38-4.04; P = 0.002). Significant interaction between ARBs and ACEIs for the risk of COVID-19 was observed in patients aged > 60 years, women, and hypertensive patients., Conclusions: This study suggests that ACEIs and ARBs are not similarly associated with COVID-19. In this retrospective series, patients with COVID-19 pneumonia more frequently had previous treatment with ARBs compared with patients without COVID-19., Competing Interests: I have read the journal's policy and the authors of this manuscript have the following competing interests: Dr. Georges has received consultant or speaker fees from AstraZeneca France, Sanofi-Aventis, Amgen, and Merck Sharpe and Dohme. The other authors have declared that no competing interests exist. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
- Published
- 2020
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