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Angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers and prognosis of hypertensive patients hospitalised with COVID-19.
Intern Med J. 2020 12; 50(12):1483-1491.IM

Abstract

BACKGROUND

Among hypertensive patients, the association between treatment with angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II receptor blockers (ARB) and the clinical severity of COVID-19, remains uncertain.

AIMS

To determine whether hypertensive patients hospitalised with COVID-19 are at risk of worse outcomes if on treatment with ACEI or ARB compared to other anti-hypertensive medications.

METHODS

This is a retrospective study conducted at a single academic medical centre (Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy) from 1 to 31 March 2020. We compared patients on treatment with an ACEI/ARB (ACEI/ARB group) to patients receiving other anti-hypertensive medications (No-ACEI/ARB group). The end-points of the study were the all-cause in-hospital death and the combination of in-hospital death or need for intensive care unit (ICU) admission.

RESULTS

The sample included 166 COVID-19 patients; median age was 74 years and 109 (66%) were men. Overall, 111 (67%) patients were taking an ACEI or ARB. Twenty-nine (17%) patients died during the hospital stay, and 51 (31%) met the combined end-point. After adjustment for comorbidities, age and degree of severity at the presentation, ACEI or ARB treatment was an independent predictor neither of in-hospital death nor of the combination of in-hospital death/need for ICU. No differences were documented between treatment with ACEI compared to ARB.

CONCLUSIONS

Among hypertensive patients hospitalised for COVID-19, treatment with ACEI or ARB is not associated with an increased risk of in-hospital death.

Links

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Authors+Show Affiliations

Covino M
Emergency Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
De Matteis G
Department of Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Burzo ML
Department of Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Santoro M
Emergency Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Fuorlo M
Emergency Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Sabia L
Emergency Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Sandroni C
Department of Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Gasbarrini A
Department of Anesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy.
Franceschi F
Emergency Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy.
Gambassi G
Department of Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome, Italy.
Gemelli Against COVID-19 Group
No affiliation info available

MeSH

AdultAgedAged, 80 and overAngiotensin Receptor AntagonistsAngiotensin-Converting Enzyme InhibitorsCOVID-19Electronic Health RecordsFemaleHospitalizationHumansHypertensionMaleMiddle AgedPrognosisRetrospective Studies

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33022124

Citation

Covino, Marcello, et al. "Angiotensin-converting Enzyme Inhibitors or Angiotensin II Receptor Blockers and Prognosis of Hypertensive Patients Hospitalised With COVID-19." Internal Medicine Journal, vol. 50, no. 12, 2020, pp. 1483-1491.
Covino M, De Matteis G, Burzo ML, et al. Angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers and prognosis of hypertensive patients hospitalised with COVID-19. Intern Med J. 2020;50(12):1483-1491.
Covino, M., De Matteis, G., Burzo, M. L., Santoro, M., Fuorlo, M., Sabia, L., Sandroni, C., Gasbarrini, A., Franceschi, F., & Gambassi, G. (2020). Angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers and prognosis of hypertensive patients hospitalised with COVID-19. Internal Medicine Journal, 50(12), 1483-1491. https://doi.org/10.1111/imj.15078
Covino M, et al. Angiotensin-converting Enzyme Inhibitors or Angiotensin II Receptor Blockers and Prognosis of Hypertensive Patients Hospitalised With COVID-19. Intern Med J. 2020;50(12):1483-1491. PubMed PMID: 33022124.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers and prognosis of hypertensive patients hospitalised with COVID-19. AU - Covino,Marcello, AU - De Matteis,Giuseppe, AU - Burzo,Maria Livia, AU - Santoro,Michele, AU - Fuorlo,Mariella, AU - Sabia,Luca, AU - Sandroni,Claudio, AU - Gasbarrini,Antonio, AU - Franceschi,Francesco, AU - Gambassi,Giovanni, AU - ,, PY - 2020/05/30/received PY - 2020/09/01/revised PY - 2020/09/10/accepted PY - 2020/10/7/pubmed PY - 2021/1/21/medline PY - 2020/10/6/entrez KW - COVID-19 KW - SARS-CoV-2 KW - angiotensin II receptor blocker KW - angiotensin-converting enzyme inhibitor KW - hypertension SP - 1483 EP - 1491 JF - Internal medicine journal JO - Intern Med J VL - 50 IS - 12 N2 - BACKGROUND: Among hypertensive patients, the association between treatment with angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II receptor blockers (ARB) and the clinical severity of COVID-19, remains uncertain. AIMS: To determine whether hypertensive patients hospitalised with COVID-19 are at risk of worse outcomes if on treatment with ACEI or ARB compared to other anti-hypertensive medications. METHODS: This is a retrospective study conducted at a single academic medical centre (Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy) from 1 to 31 March 2020. We compared patients on treatment with an ACEI/ARB (ACEI/ARB group) to patients receiving other anti-hypertensive medications (No-ACEI/ARB group). The end-points of the study were the all-cause in-hospital death and the combination of in-hospital death or need for intensive care unit (ICU) admission. RESULTS: The sample included 166 COVID-19 patients; median age was 74 years and 109 (66%) were men. Overall, 111 (67%) patients were taking an ACEI or ARB. Twenty-nine (17%) patients died during the hospital stay, and 51 (31%) met the combined end-point. After adjustment for comorbidities, age and degree of severity at the presentation, ACEI or ARB treatment was an independent predictor neither of in-hospital death nor of the combination of in-hospital death/need for ICU. No differences were documented between treatment with ACEI compared to ARB. CONCLUSIONS: Among hypertensive patients hospitalised for COVID-19, treatment with ACEI or ARB is not associated with an increased risk of in-hospital death. SN - 1445-5994 UR - https://www.unboundmedicine.com/medline/citation/33022124/Angiotensin_converting_enzyme_inhibitors_or_angiotensin_II_receptor_blockers_and_prognosis_of_hypertensive_patients_hospitalised_with_COVID_19_ DB - PRIME DP - Unbound Medicine ER -
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