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No association between use of angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers prior to hospital admission and clinical course of COVID-19 in the COvid MEdicaTion (COMET) study.
Br J Clin Pharmacol. 2021 08; 87(8):3301-3309.BJ

Abstract

Since the outbreak of SARS-CoV-2, also known as COVID-19, conflicting theories have circulated on the influence of angiotensin-converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB) on incidence and clinical course of COVID-19, but data are scarce. The COvid MEdicaTion (COMET) study is an observational, multinational study that focused on the clinical course of COVID-19 (i.e. hospital mortality and intensive care unit [ICU] admission), and included COVID-19 patients who were registered at the emergency department or admitted to clinical wards of 63 participating hospitals. Pharmacists, clinical pharmacologists or treating physicians collected data on medication prescribed prior to admission. The association between the medication and composite clinical endpoint, including mortality and ICU admission, was analysed by multivariable logistic regression models to adjust for potential confounders. A total of 4870 patients were enrolled. ACEi were used by 847 (17.4%) patients and ARB by 761 (15.6%) patients. No significant association was seen with ACEi and the composite endpoint (adjusted odds ratio [OR] 0.94; 95% confidence interval [CI] 0.79 to 1.12), mortality (OR 1.03; 95%CI 0.84 to 1.27) or ICU admission (OR 0.96; 95%CI 0.78 to 1.19) after adjustment for covariates. Similarly, no association was observed between ARB and the composite endpoint (OR 1.09; 95%CI 0.90 to 1.30), mortality (OR 1.12; OR 0.90 to 1.39) or ICU admission (OR 1.21; 95%CI 0.98 to 1.49). In conclusion, we found no evidence of a harmful or beneficial effect of ACEi or ARB use prior to hospital admission on ICU admission or hospital mortality.

Authors+Show Affiliations

Departments of Internal Medicine, Erasmus MC University Medical Centre, Rotterdam, The Netherlands.Hospital Pharmacy, Erasmus MC University Medical Centre, Rotterdam, The Netherlands.Departments of Internal Medicine, Erasmus MC University Medical Centre, Rotterdam, The Netherlands.Digitalis Rx BV, Amsterdam, The Netherlands.Department of Clinical Decision Support, Health Base Foundation, Houten, The Netherlands.Cardiology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands.Departments of Internal Medicine, Erasmus MC University Medical Centre, Rotterdam, The Netherlands. Hospital Pharmacy, Erasmus MC University Medical Centre, Rotterdam, The Netherlands.Hospital Pharmacy, Erasmus MC University Medical Centre, Rotterdam, The Netherlands.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33507556

Citation

Sablerolles, Roos S G., et al. "No Association Between Use of Angiotensin-converting Enzyme Inhibitors or Angiotensin II Receptor Blockers Prior to Hospital Admission and Clinical Course of COVID-19 in the COvid MEdicaTion (COMET) Study." British Journal of Clinical Pharmacology, vol. 87, no. 8, 2021, pp. 3301-3309.
Sablerolles RSG, Hogenhuis FEF, Lafeber M, et al. No association between use of angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers prior to hospital admission and clinical course of COVID-19 in the COvid MEdicaTion (COMET) study. Br J Clin Pharmacol. 2021;87(8):3301-3309.
Sablerolles, R. S. G., Hogenhuis, F. E. F., Lafeber, M., van de Loo, B. P. A., Borgsteede, S. D., Boersma, E., Versmissen, J., & van der Kuy, H. (2021). No association between use of angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers prior to hospital admission and clinical course of COVID-19 in the COvid MEdicaTion (COMET) study. British Journal of Clinical Pharmacology, 87(8), 3301-3309. https://doi.org/10.1111/bcp.14751
Sablerolles RSG, et al. No Association Between Use of Angiotensin-converting Enzyme Inhibitors or Angiotensin II Receptor Blockers Prior to Hospital Admission and Clinical Course of COVID-19 in the COvid MEdicaTion (COMET) Study. Br J Clin Pharmacol. 2021;87(8):3301-3309. PubMed PMID: 33507556.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - No association between use of angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers prior to hospital admission and clinical course of COVID-19 in the COvid MEdicaTion (COMET) study. AU - Sablerolles,Roos S G, AU - Hogenhuis,Freija E F, AU - Lafeber,Melvin, AU - van de Loo,Bob P A, AU - Borgsteede,Sander D, AU - Boersma,Eric, AU - Versmissen,Jorie, AU - van der Kuy,Hugo, AU - ,, Y1 - 2021/02/18/ PY - 2020/12/23/revised PY - 2020/07/21/received PY - 2021/01/05/accepted PY - 2021/1/29/pubmed PY - 2021/8/7/medline PY - 2021/1/28/entrez KW - COVID-19 KW - SARS-CoV-2 KW - angiotensin II receptor blocker KW - angiotensin-converting enzyme inhibitor KW - mortality SP - 3301 EP - 3309 JF - British journal of clinical pharmacology JO - Br J Clin Pharmacol VL - 87 IS - 8 N2 - Since the outbreak of SARS-CoV-2, also known as COVID-19, conflicting theories have circulated on the influence of angiotensin-converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB) on incidence and clinical course of COVID-19, but data are scarce. The COvid MEdicaTion (COMET) study is an observational, multinational study that focused on the clinical course of COVID-19 (i.e. hospital mortality and intensive care unit [ICU] admission), and included COVID-19 patients who were registered at the emergency department or admitted to clinical wards of 63 participating hospitals. Pharmacists, clinical pharmacologists or treating physicians collected data on medication prescribed prior to admission. The association between the medication and composite clinical endpoint, including mortality and ICU admission, was analysed by multivariable logistic regression models to adjust for potential confounders. A total of 4870 patients were enrolled. ACEi were used by 847 (17.4%) patients and ARB by 761 (15.6%) patients. No significant association was seen with ACEi and the composite endpoint (adjusted odds ratio [OR] 0.94; 95% confidence interval [CI] 0.79 to 1.12), mortality (OR 1.03; 95%CI 0.84 to 1.27) or ICU admission (OR 0.96; 95%CI 0.78 to 1.19) after adjustment for covariates. Similarly, no association was observed between ARB and the composite endpoint (OR 1.09; 95%CI 0.90 to 1.30), mortality (OR 1.12; OR 0.90 to 1.39) or ICU admission (OR 1.21; 95%CI 0.98 to 1.49). In conclusion, we found no evidence of a harmful or beneficial effect of ACEi or ARB use prior to hospital admission on ICU admission or hospital mortality. SN - 1365-2125 UR - https://www.unboundmedicine.com/medline/citation/33507556/No_association_between_use_of_angiotensin_converting_enzyme_inhibitors_or_angiotensin_II_receptor_blockers_prior_to_hospital_admission_and_clinical_course_of_COVID_19_in_the_COvid_MEdicaTion__COMET__study_ DB - PRIME DP - Unbound Medicine ER -