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Treatment with ACE inhibitors or ARBs and risk of severe/lethal COVID-19: a meta-analysis
- Source :
- Heart
- Publication Year :
- 2020
- Publisher :
- BMJ, 2020.
-
Abstract
- ObjectiveIt has been hypothesised that the use of ACE inhibitors and angiotensin receptor blockers (ARBs) might either increase or reduce the risk of severe or lethal COVID-19. The findings from the available observational studies varied, and summary estimates are urgently needed to elucidate whether these drugs should be suspended during the pandemic, or patients and physicians should be definitely reassured. This meta-analysis of adjusted observational data aimed to summarise the existing evidence on the association between these medications and severe/lethal COVID-19.MethodsWe searched MedLine, Scopus and preprint repositories up to 8 June 2020 to retrieve cohort or case–control studies comparing the risk of severe/fatal COVID-19 (either mechanical ventilation, intensive care unit admission or death), among hypertensive subjects treated with: (1) ACE inhibitors, (2) ARBs and (3) both, versus untreated subjects. Data were combined using a random-effect generic inverse variance approach.ResultsTen studies, enrolling 9890 hypertensive subjects were included in the analyses. Compared with untreated subjects, those using either ACE inhibitors or ARBs showed a similar risk of severe or lethal COVID-19 (summary OR: 0.90; 95% CI 0.65 to 1.26 for ACE inhibitors; 0.92; 95% CI 0.75 to 1.12 for ARBs). The results did not change when both drugs were considered together, when death was the outcome and excluding the studies with significant, divergent results.ConclusionThe present meta-analysis strongly supports the recommendation of several scientific societies to continue ARBs or ACE inhibitors for all patients, unless otherwise advised by their physicians who should thus be reassured.
- Subjects :
- medicine.medical_specialty
hypertension
cardiac risk factors and prevention
meta-analysis
SARS-COV-2, Covid-19, ace inhibitors, ARBS, meta-analysis
Coronavirus disease 2019 (COVID-19)
medicine.medical_treatment
Pneumonia, Viral
MEDLINE
Socio-culturale
Angiotensin-Converting Enzyme Inhibitors
SARS-COV-2
Coronary Artery Disease
meta-analysi
law.invention
Angiotensin Receptor Antagonists
Betacoronavirus
law
Internal medicine
medicine
Humans
ace inhibitor
Pandemics
Mechanical ventilation
business.industry
Intensive care unit
Cardiac Risk Factors and Prevention
ace inhibitors
Meta-analysis
Cohort
Observational study
Angiotensin Receptor Blockers
ARBS
Coronavirus Infections
Covid-19
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 1468201X and 13556037
- Volume :
- 106
- Database :
- OpenAIRE
- Journal :
- Heart
- Accession number :
- edsair.doi.dedup.....60c735940e86ee2793079fc9534a7ede