| Title: |
Safety of ACE-I and ARB medications in COVID-19: A retrospective cohort study of inpatients and outpatients in California |
| Authors: |
Samuel J. S. Rubin; Samuel R. Falkson; Nicholas R. Degner; Catherine A. Blish |
| Source: |
Journal of Clinical and Translational Science, Vol 5 (2021) |
| Publisher Information: |
Cambridge University Press |
| Publication Year: |
2021 |
| Collection: |
Directory of Open Access Journals: DOAJ Articles |
| Subject Terms: |
COVID-19; SARS-CoV-2; ACE inhibitors (ACE-I); translational science; angiotensin II receptor blockers (ARB); hypertension; renin-angiotensin-aldosterone system (RAAS); Medicine |
| Description: |
Introduction: There is significant interest in the use of angiotensin converting enzyme inhibitors (ACE-I) and angiotensin II receptor blockers (ARB) in coronavirus disease 2019 (COVID-19) and concern over potential adverse effects since these medications upregulate the severe acute respiratory syndrome coronavirus 2 host cell entry receptor ACE2. Recent studies on ACE-I and ARB in COVID-19 were limited by excluding outpatients, excluding patients by age, analyzing ACE-I and ARB together, imputing missing data, and/or diagnosing COVID-19 by chest computed tomography without definitive reverse transcription polymerase chain reaction (RT-PCR), all of which are addressed here. Methods: We performed a retrospective cohort study of 1023 COVID-19 patients diagnosed by RT-PCR at Stanford Hospital through April 8, 2020 with a minimum follow-up time of 14 days to investigate the association between ACE-I or ARB use with outcomes. Results: Use of ACE-I or ARB medications was not associated with increased risk of hospitalization, intensive care unit admission, or death. Compared to patients with charted past medical history, there was a lower risk of hospitalization for patients on ACE-I (odds ratio (OR) 0.43; 95% confidence interval (CI) 0.19–0.97; P = 0.0426) and ARB (OR 0.39; 95% CI 0.17–0.90; P = 0.0270). Compared to patients with hypertension not on ACE-I or ARB, patients on ARB medications had a lower risk of hospitalization (OR 0.09; 95% CI 0.01–0.88; P = 0.0381). Conclusions: These findings suggest that the use of ACE-I and ARB is not associated with adverse outcomes and may be associated with improved outcomes in COVID-19, which is immediately relevant to care of the many patients on these medications. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
https://www.cambridge.org/core/product/identifier/S2059866120004896/type/journal_article; https://doaj.org/toc/2059-8661; https://doaj.org/article/8e764b7d47254a0e85a3a1a8fc8b9a3f |
| DOI: |
10.1017/cts.2020.489 |
| Availability: |
https://doi.org/10.1017/cts.2020.489; https://doaj.org/article/8e764b7d47254a0e85a3a1a8fc8b9a3f |
| Accession Number: |
edsbas.4DB7F0CC |
| Database: |
BASE |