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[Association of hypertension and antihypertensive agents and the severity of COVID-19 pneumonia. A monocentric French prospective study].
Ann Cardiol Angeiol (Paris). 2020 Nov; 69(5):247-254.AC

Abstract

BACKGROUND AND AIM

Angiotensin converting enzyme (ACE) type 2 is the receptor of SARSCoV-2 for cell entry into lung cells. Because ACE-2 may be modulated by ACE inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs), there are concern that patients treated with ACEIs and ARBs are at higher risk for COVID-19 infection or severity. This study sought to analyse the association of severe forms of COVID-19 and mortality with hypertension and a previous treatment with ACEI and ARB.

METHODS

Prospective follow-up of 433 consecutive patients hospitalised for COVID-19 pneumonia confirmed by PCR or highly probable on clinical, biological, and radiological findings, and included in the COVHYP study. Mortality and severe COVID-19 (criteria: death, intensive care unit, or hospitalisation >30 days) were compared in patients receiving or not ACEIs and ARBs. Follow-up was 100% at hospital discharge, and 96.5% at >1month.

RESULTS

Age was 63.6±18.7 years, and 40%) were female. At follow-up (mean 78±50 days), 136 (31%) patients had severity criteria (death, 64 ; intensive care unit, 73; hospital stay >30 days, 49). Hypertension (55.1% vs 36.7%, P<0.001) and antihypertensive treatment were associated with severe COVID-19 and mortality. The association between ACEI/ARB treatment and COVID-19 severity criteria found in univariate analysis (Odds Ratio 1.74, 95%CI [1.14-2.64], P=0.01) was not confirmed when adjusted on age, gender, and hypertension (adjusted OR1.13 [0.59-2.15], P=0.72). Diabetes and hypothyroidism were associated with severe COVID-19, whereas history of asthma was not.

CONCLUSION

This study suggests that previous treatment with ACEI and ARB is not associated with hospital mortality, 1- and 2-month mortality, and severity criteria in patients hospitalised for COVID-19. No protective effect of ACEIs and ARBs on severe pneumonia related to COVID-19 was demonstrated.

Authors+Show Affiliations

Service de cardiologie, Centre Hospitalier de Versailles, Le Chesnay, France. Electronic address: jgeorges@ch-versailles.fr.Service de cardiologie, Centre Hospitalier de Versailles, Le Chesnay, France.Service de cardiologie, Centre Hospitalier de Versailles, Le Chesnay, France.Service de cardiologie, Centre Hospitalier de Versailles, Le Chesnay, France.Service de cardiologie, Centre Hospitalier de Versailles, Le Chesnay, France.Service de cardiologie, Centre Hospitalier de Versailles, Le Chesnay, France.Service de cardiologie, Centre Hospitalier de Versailles, Le Chesnay, France.Service de cardiologie, Centre Hospitalier de Versailles, Le Chesnay, France.Service de cardiologie, Centre Hospitalier de Versailles, Le Chesnay, France.Service de cardiologie, Centre Hospitalier de Versailles, Le Chesnay, France.Service de cardiologie, Centre Hospitalier de Versailles, Le Chesnay, France.Service de cardiologie, Centre Hospitalier de Versailles, Le Chesnay, France.Service de cardiologie, Centre Hospitalier de Versailles, Le Chesnay, France.Service de cardiologie, Centre Hospitalier de Versailles, Le Chesnay, France.Service d'accueil des urgences, Centre Hospitalier de Versailles, Le Chesnay, France.Service de diabétologie, Centre Hospitalier de Versailles, Le Chesnay, France.Service de cardiologie, Centre Hospitalier de Versailles, Le Chesnay, France.

Pub Type(s)

Journal Article

Language

fre

PubMed ID

33039120

Citation

Georges, J-L, et al. "[Association of Hypertension and Antihypertensive Agents and the Severity of COVID-19 Pneumonia. a Monocentric French Prospective Study]." Annales De Cardiologie Et D'angeiologie, vol. 69, no. 5, 2020, pp. 247-254.
Georges JL, Cochet H, Roger G, et al. [Association of hypertension and antihypertensive agents and the severity of COVID-19 pneumonia. A monocentric French prospective study]. Ann Cardiol Angeiol (Paris). 2020;69(5):247-254.
Georges, J. L., Cochet, H., Roger, G., Ben Jemaa, H., Soltani, J., Azowa, J. B., Mamou, R., Gilles, F., Saba, J., Prevot, A., Pasqualini, M., Monguillon, V., De Tournemire, M., Bertrand, A., Koukabi-Fradelizi, M., Beressi, J. P., & Livarek, B. (2020). [Association of hypertension and antihypertensive agents and the severity of COVID-19 pneumonia. A monocentric French prospective study]. Annales De Cardiologie Et D'angeiologie, 69(5), 247-254. https://doi.org/10.1016/j.ancard.2020.09.030
Georges JL, et al. [Association of Hypertension and Antihypertensive Agents and the Severity of COVID-19 Pneumonia. a Monocentric French Prospective Study]. Ann Cardiol Angeiol (Paris). 2020;69(5):247-254. PubMed PMID: 33039120.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Association of hypertension and antihypertensive agents and the severity of COVID-19 pneumonia. A monocentric French prospective study]. AU - Georges,J-L, AU - Cochet,H, AU - Roger,G, AU - Ben Jemaa,H, AU - Soltani,J, AU - Azowa,J-B, AU - Mamou,R, AU - Gilles,F, AU - Saba,J, AU - Prevot,A, AU - Pasqualini,M, AU - Monguillon,V, AU - De Tournemire,M, AU - Bertrand,A, AU - Koukabi-Fradelizi,M, AU - Beressi,J-P, AU - Livarek,B, Y1 - 2020/09/29/ PY - 2020/09/02/received PY - 2020/09/18/accepted PY - 2020/10/12/pubmed PY - 2020/11/12/medline PY - 2020/10/11/entrez KW - Angiotensin II Receptor Blockers KW - Angiotensin-Converting Enzyme Inhibitors KW - Antagoniste des récepteurs à l’Angiotensine II KW - COVID-19 KW - Hypertension KW - Inhibiteurs de l’enzyme de conversion KW - Renin-Angiotensin System KW - Système Rénine-Angiotensine-Aldostérone SP - 247 EP - 254 JF - Annales de cardiologie et d'angeiologie JO - Ann Cardiol Angeiol (Paris) VL - 69 IS - 5 N2 - BACKGROUND AND AIM: Angiotensin converting enzyme (ACE) type 2 is the receptor of SARSCoV-2 for cell entry into lung cells. Because ACE-2 may be modulated by ACE inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs), there are concern that patients treated with ACEIs and ARBs are at higher risk for COVID-19 infection or severity. This study sought to analyse the association of severe forms of COVID-19 and mortality with hypertension and a previous treatment with ACEI and ARB. METHODS: Prospective follow-up of 433 consecutive patients hospitalised for COVID-19 pneumonia confirmed by PCR or highly probable on clinical, biological, and radiological findings, and included in the COVHYP study. Mortality and severe COVID-19 (criteria: death, intensive care unit, or hospitalisation >30 days) were compared in patients receiving or not ACEIs and ARBs. Follow-up was 100% at hospital discharge, and 96.5% at >1month. RESULTS: Age was 63.6±18.7 years, and 40%) were female. At follow-up (mean 78±50 days), 136 (31%) patients had severity criteria (death, 64 ; intensive care unit, 73; hospital stay >30 days, 49). Hypertension (55.1% vs 36.7%, P<0.001) and antihypertensive treatment were associated with severe COVID-19 and mortality. The association between ACEI/ARB treatment and COVID-19 severity criteria found in univariate analysis (Odds Ratio 1.74, 95%CI [1.14-2.64], P=0.01) was not confirmed when adjusted on age, gender, and hypertension (adjusted OR1.13 [0.59-2.15], P=0.72). Diabetes and hypothyroidism were associated with severe COVID-19, whereas history of asthma was not. CONCLUSION: This study suggests that previous treatment with ACEI and ARB is not associated with hospital mortality, 1- and 2-month mortality, and severity criteria in patients hospitalised for COVID-19. No protective effect of ACEIs and ARBs on severe pneumonia related to COVID-19 was demonstrated. SN - 1768-3181 UR - https://www.unboundmedicine.com/medline/citation/33039120/[Association_of_hypertension_and_antihypertensive_agents_and_the_severity_of_COVID_19_pneumonia__A_monocentric_French_prospective_study]_ DB - PRIME DP - Unbound Medicine ER -