TY - JOUR T1 - Angiotensin-Converting Enzyme (ACE) Inhibitors and Angiotensin Receptor Blockers (ARB) Are Protective Against ICU Admission and Mortality for Patients With COVID-19 Disease. AU - ElAbd,Rawan, AU - AlTarrah,Dana, AU - AlYouha,Sarah, AU - Bastaki,Hamad, AU - Almazeedi,Sulaiman, AU - Al-Haddad,Mohannad, AU - Jamal,Mohammad, AU - AlSabah,Salman, Y1 - 2021/03/04/ PY - 2020/08/29/received PY - 2021/02/12/accepted PY - 2021/3/22/entrez PY - 2021/3/23/pubmed PY - 2021/3/23/medline KW - ACEi (angiotensin conversing enzyme inhibitor) KW - ARB (angiotensin II AT1 receptor blocker) KW - COVID−19 KW - ICU–intensive care unit KW - mortality SP - 600385 EP - 600385 JF - Frontiers in medicine JO - Front Med (Lausanne) VL - 8 N2 - Introduction: Corona Virus disease 2019 (COVID-19) caused by the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) has become a global pandemic. The aim of this study was to investigate the impact of being on an Angiotensin-Converting Enzyme Inhibitors (ACEI) and/or Angiotensin Receptor Blockers (ARB) on hospital admission, on the following COVID-19 outcomes: disease severity, ICU admission, and mortality. Methods: The charts of all patients consecutively diagnosed with COVID-19 from the 24th of February to the 16th of June of the year 2020 in Jaber Al-Ahmed Al-Sabah hospital in Kuwait were checked. All related patient information and clinical data was retrieved from the hospitals electronic medical record system. The primary outcome was COVID-19 disease severity defined as the need for Intensive Care Unit (ICU) admission. Secondary outcome was mortality. Results: A total of 4,019 COVID-19 patients were included, of which 325 patients (8.1%) used ACEI/ARB, users of ACEI/ARB were found to be significantly older (54.4 vs. 40.5 years). ACEI/ARB users were found to have more co-morbidities; diabetes (45.8 vs. 14.8%) and hypertension (92.9 vs. 13.0%). ACEI/ARB use was found to be significantly associated with greater risk of ICU admission in the unadjusted analysis [OR, 1.51 (95% CI: 1.04-2.19), p = 0.028]. After adjustment for age, gender, nationality, coronary artery disease, diabetes and hypertension, ICU admission was found to be inversely associated with ACEI use [OR, 0.57 (95% CI: 0.34-0.88), p = 0.01] and inversely associated with mortality [OR, 0.56 (95% CI: 0.33-0.95), p = 0.032]. Conclusion: The current evidence in the literature supports continuation of ACEI/ARB medications for patients with co-morbidities that acquire COVID-19 infection. Although, the protective effects of such medications on COVID-19 disease severity and mortality remain unclear, the findings of the present study support the use of ACEI/ARB medication. SN - 2296-858X UR - https://www.unboundmedicine.com/medline/citation/33748156/Angiotensin_Converting_Enzyme__ACE__Inhibitors_and_Angiotensin_Receptor_Blockers__ARB__Are_Protective_Against_ICU_Admission_and_Mortality_for_Patients_With_COVID_19_Disease_ DB - PRIME DP - Unbound Medicine ER -