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Use of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers in context of COVID-19 outbreak: a retrospective analysis.
Front Med. 2020 Oct; 14(5):601-612.FM

Abstract

The possible effects of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) on COVID-19 disease severity have generated considerable debate. We performed a single-center, retrospective analysis of hospitalized adult COVID-19 patients in Wuhan, China, who had definite clinical outcome (dead or discharged) by February 15, 2020. Patients on anti-hypertensive treatment with or without ACEI/ARB were compared on their clinical characteristics and outcomes. The medical records from 702 patients were screened. Among the 101 patients with a history of hypertension and taking at least one anti-hypertensive medication, 40 patients were receiving ACEI/ARB as part of their regimen, and 61 patients were on antihypertensive medication other than ACEI/ARB. We observed no statistically significant differences in percentages of in-hospital mortality (28% vs. 34%, P = 0.46), ICU admission (20% vs. 28%, P = 0.37) or invasive mechanical ventilation (18% vs. 26%, P = 0.31) between patients with or without ACEI/ARB treatment. Further multivariable adjustment of age and gender did not provide evidence for a significant association between ACEI/ARB treatment and severe COVID-19 outcomes. Our findings confirm the lack of an association between chronic receipt of renin-angiotensin system antagonists and severe outcomes of COVID-19. Patients should continue previous anti-hypertensive therapy until further evidence is available.

Authors+Show Affiliations

Department of Basic Medical Sciences, Tsinghua University School of Medicine, Beijing, 100084, China.Department of Infectious Diseases, Jinyintan Hospital, Wuhan, 430030, China.Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, 100029, China. Institute of Respiratory Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China. Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, 100029, China.Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, 100029, China. Institute of Respiratory Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, 100029, China. Institute of Respiratory Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China. Beijing University of Chinese Medicine, Beijing, 100029, China.Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, 100029, China. Institute of Respiratory Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, 100029, China. Institute of Respiratory Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China. Department of Respiratory Medicine, Capital Medical University, Beijing, 100029, China.Department of Basic Medical Sciences, Tsinghua University School of Medicine, Beijing, 100084, China.Department of Basic Medical Sciences, Tsinghua University School of Medicine, Beijing, 100084, China.Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, 100029, China. Department of Respiratory Medicine, Capital Medical University, Beijing, 100029, China.Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, 100029, China. Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China.Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, 100029, China. Department of Respiratory Medicine, Capital Medical University, Beijing, 100029, China.Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, 100029, China. Institute of Respiratory Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China. Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, 100029, China.Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, 100029, China. Institute of Respiratory Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, 100029, China. Institute of Respiratory Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, 100029, China. Institute of Respiratory Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, 22904, USA.Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, OX1 2JD, UK.Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, 100029, China. caobin_ben@163.com. Institute of Respiratory Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China. caobin_ben@163.com. Department of Respiratory Medicine, Capital Medical University, Beijing, 100029, China. caobin_ben@163.com. Tsinghua University-Peking University Joint Center for Life Sciences, Beijing, 100084, China. caobin_ben@163.com.Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, 100029, China. wangchen@pumc.edu.cn. Institute of Respiratory Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China. wangchen@pumc.edu.cn. Tsinghua University-Peking University Joint Center for Life Sciences, Beijing, 100084, China. wangchen@pumc.edu.cn. Chinese Academy of Engineering, Beijing, 100088, China. wangchen@pumc.edu.cn.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32621202

Citation

Xu, Jiuyang, et al. "Use of Angiotensin-converting Enzyme Inhibitors and Angiotensin II Receptor Blockers in Context of COVID-19 Outbreak: a Retrospective Analysis." Frontiers of Medicine, vol. 14, no. 5, 2020, pp. 601-612.
Xu J, Huang C, Fan G, et al. Use of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers in context of COVID-19 outbreak: a retrospective analysis. Front Med. 2020;14(5):601-612.
Xu, J., Huang, C., Fan, G., Liu, Z., Shang, L., Zhou, F., Wang, Y., Yu, J., Yang, L., Xie, K., Huang, Z., Huang, L., Gu, X., Li, H., Zhang, Y., Wang, Y., Hayden, F. G., Horby, P. W., Cao, B., & Wang, C. (2020). Use of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers in context of COVID-19 outbreak: a retrospective analysis. Frontiers of Medicine, 14(5), 601-612. https://doi.org/10.1007/s11684-020-0800-y
Xu J, et al. Use of Angiotensin-converting Enzyme Inhibitors and Angiotensin II Receptor Blockers in Context of COVID-19 Outbreak: a Retrospective Analysis. Front Med. 2020;14(5):601-612. PubMed PMID: 32621202.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers in context of COVID-19 outbreak: a retrospective analysis. AU - Xu,Jiuyang, AU - Huang,Chaolin, AU - Fan,Guohui, AU - Liu,Zhibo, AU - Shang,Lianhan, AU - Zhou,Fei, AU - Wang,Yeming, AU - Yu,Jiapei, AU - Yang,Luning, AU - Xie,Ke, AU - Huang,Zhisheng, AU - Huang,Lixue, AU - Gu,Xiaoying, AU - Li,Hui, AU - Zhang,Yi, AU - Wang,Yimin, AU - Hayden,Frederick G, AU - Horby,Peter W, AU - Cao,Bin, AU - Wang,Chen, Y1 - 2020/07/03/ PY - 2020/05/26/received PY - 2020/06/03/accepted PY - 2020/7/6/pubmed PY - 2020/10/30/medline PY - 2020/7/5/entrez KW - COVID-19 KW - SARS-CoV-2 KW - angiotensin II receptor blocker KW - angiotensin-converting enzyme inhibitor KW - hypertension SP - 601 EP - 612 JF - Frontiers of medicine JO - Front Med VL - 14 IS - 5 N2 - The possible effects of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) on COVID-19 disease severity have generated considerable debate. We performed a single-center, retrospective analysis of hospitalized adult COVID-19 patients in Wuhan, China, who had definite clinical outcome (dead or discharged) by February 15, 2020. Patients on anti-hypertensive treatment with or without ACEI/ARB were compared on their clinical characteristics and outcomes. The medical records from 702 patients were screened. Among the 101 patients with a history of hypertension and taking at least one anti-hypertensive medication, 40 patients were receiving ACEI/ARB as part of their regimen, and 61 patients were on antihypertensive medication other than ACEI/ARB. We observed no statistically significant differences in percentages of in-hospital mortality (28% vs. 34%, P = 0.46), ICU admission (20% vs. 28%, P = 0.37) or invasive mechanical ventilation (18% vs. 26%, P = 0.31) between patients with or without ACEI/ARB treatment. Further multivariable adjustment of age and gender did not provide evidence for a significant association between ACEI/ARB treatment and severe COVID-19 outcomes. Our findings confirm the lack of an association between chronic receipt of renin-angiotensin system antagonists and severe outcomes of COVID-19. Patients should continue previous anti-hypertensive therapy until further evidence is available. SN - 2095-0225 UR - https://www.unboundmedicine.com/medline/citation/32621202/Use_of_angiotensin_converting_enzyme_inhibitors_and_angiotensin_II_receptor_blockers_in_context_of_COVID_19_outbreak:_a_retrospective_analysis_ L2 - https://dx.doi.org/10.1007/s11684-020-0800-y DB - PRIME DP - Unbound Medicine ER -