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Title: Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers Withdrawal Is Associated with Higher Mortality in Hospitalized Patients with COVID-19
Author: Roy Vallejo, Emilia
Sánchez Purificación, Aquilino
Torres Peña, José
Sánchez Moreno, Beatriz
Arnalich, Francisco
García Blanco, María
López Miranda, José
Romero Cabrera, Juan
Herrero Gil, Carmen
Bascunana, José
Rubio Rivas, Manuel
Pintos Otero, Sara
Martínez Sempere, Verónica
Ballano Rodríguez-Solís, Jesús
Gil Sánchez, Ricardo
Luque del Pino, Jairo
González Noya, Amara
Navas Alcántara, María
Cortés Rodríguez, Begoña
Alcalá, José
Suárez Lombraña, Ana
Andrés Soler, Jorge
Gómez Huelgas, Ricardo
Casas Rojo, José
Millán Núñez-Cortés, Jesús
SEMI-COVID-19 Network
Keywords: COVID-19
Pacients hospitalitzats
Pronòstic mèdic
Hospital patients
Issue Date: 15-Jun-2021
Publisher: MDPI AG
Abstract: Our main aim was to describe the effect on the severity of ACEI (angiotensin-converting enzyme inhibitor) and ARB (angiotensin II receptor blocker) during COVID-19 hospitalization. A retrospective, observational, multicenter study evaluating hospitalized patients with COVID-19 treated with ACEI/ARB. The primary endpoint was the incidence of the composite outcome of prognosis (IMV (invasive mechanical ventilation), NIMV (non-invasive mechanical ventilation), ICU admission (intensive care unit), and/or all-cause mortality). We evaluated both outcomes in patients whose treatment with ACEI/ARB was continued or withdrawn. Between February and June 2020, 11,205 patients were included, mean age 67 years (SD = 16.3) and 43.1% female; 2162 patients received ACEI/ARB treatment. ACEI/ARB treatment showed lower all-cause mortality (p < 0.0001). Hypertensive patients in the ACEI/ARB group had better results in IMV, ICU admission, and the composite outcome of prognosis (p < 0.0001 for all). No differences were found in the incidence of major adverse cardiovascular events. Patients previously treated with ACEI/ARB continuing treatment during hospitalization had a lower incidence of the composite outcome of prognosis than those whose treatment was withdrawn (RR 0.67, 95%CI 0.63-0.76). ARB was associated with better survival than ACEI (HR 0.77, 95%CI 0.62-0.96). ACEI/ARB treatment during COVID-19 hospitalization was associated with protection on mortality. The benefits were greater in hypertensive, those who continued
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It is part of: Journal of Clinical Medicine, 2021, vol. 10, num. 12, p. 2642
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ISSN: 2077-0383
Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

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