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Effects of Angiotensin Receptor Blockers (ARBs) on In-Hospital Outcomes of Patients With Hypertension and Confirmed or Clinically Suspected COVID-19.
- Source :
-
American journal of hypertension [Am J Hypertens] 2020 Dec 31; Vol. 33 (12), pp. 1102-1111. - Publication Year :
- 2020
-
Abstract
- Background: There is an ongoing controversy about harms and benefits of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) in hypertensive patients with coronavirus disease 2019 (COVID-19). Given the unresolved debate, we investigated the association of ARBs with in-hospital outcomes of these patients.<br />Methods: In this retrospective observational study, we studied patients with COVID-19 who referred to Sina Hospital in Tehran, Iran, from 20 February to 29 May 2020. Patients with either positive real-time reverse-transcriptase polymerase-chain-reaction test of swab specimens, or high clinical suspicion according to the World Health Organization's interim guidance were included. We followed-up patients for incurring death, severe COVID-19, and in-hospital complications.<br />Results: We evaluated 681 patients with COVID-19 of whom 37 patients were excluded due to incomplete medical records and 8 patients who used ACEIs which left 636 patients in the analysis. In this cohort, 108 (17.0%) patients expired and 407 (64.0%) patients incurred severe COVID-19. Of 254 (39.9%) patients with hypertension, 122 (48.0%) patients were receiving an ARB. After adjustment for possible confounders, we found no independent association between taking ARBs and in-hospital outcomes except for acute kidney injury (AKI), in patients with confirmed or clinically suspected COVID-19, either hypertensive or not-hypertensive. We found that discontinuation of ARBs during hospitalization was associated with a greater risk of mortality, invasive ventilation, and AKI (all P ˂ 0.002).<br />Conclusions: We found that taking ARBs by patients with hypertension and confirmed or clinically suspected COVID-19 is not associated with poorer in-hospital outcomes after adjustment for possible confounders.<br /> (© American Journal of Hypertension, Ltd 2020. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)
- Subjects :
- Acute Kidney Injury mortality
Aged
Angiotensin Receptor Antagonists adverse effects
Antihypertensive Agents adverse effects
COVID-19 diagnosis
COVID-19 mortality
Female
Hospital Mortality
Hospitalization
Humans
Hypertension diagnosis
Hypertension mortality
Iran
Male
Middle Aged
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Angiotensin Receptor Antagonists therapeutic use
Antihypertensive Agents therapeutic use
COVID-19 therapy
Hypertension drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1941-7225
- Volume :
- 33
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- American journal of hypertension
- Publication Type :
- Academic Journal
- Accession number :
- 32920644
- Full Text :
- https://doi.org/10.1093/ajh/hpaa149