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- Title
Continued In-Hospital Angiotensin-Converting Enzyme Inhibitor and Angiotensin II Receptor Blocker Use in Hypertensive COVID-19 Patients Is Associated With Positive Clinical Outcome.
- Authors
Lam, Katherine W; Chow, Kenneth W; Vo, Jonathan; Hou, Wei; Li, Haifang; Richman, Paul S; Mallipattu, Sandeep K; Skopicki, Hal A; Singer, Adam J; Duong, Tim Q
- Abstract
<bold>Background: </bold>This study investigated continued and discontinued use of angiotensin-converting enzyme inhibitors (ACEi) or angiotensin II receptor blockers (ARB) during hospitalization of 614 hypertensive laboratory-confirmed COVID-19 patients.<bold>Methods: </bold>Demographics, comorbidities, vital signs, laboratory data, and ACEi/ARB usage were analyzed. To account for confounders, patients were substratified by whether they developed hypotension and acute kidney injury (AKI) during the index hospitalization.<bold>Results: </bold>Mortality (22% vs 17%, P > .05) and intensive care unit (ICU) admission (26% vs 12%, P > .05) rates were not significantly different between non-ACEi/ARB and ACEi/ARB groups. However, patients who continued ACEi/ARBs in the hospital had a markedly lower ICU admission rate (12% vs 26%; P = .001; odds ratio [OR] = 0.347; 95% confidence interval [CI], .187-.643) and mortality rate (6% vs 28%; P = .001; OR = 0.215; 95% CI, .101-.455) compared to patients who discontinued ACEi/ARB. The odds ratio for mortality remained significantly lower after accounting for development of hypotension or AKI.<bold>Conclusions: </bold>These findings suggest that continued ACEi/ARB use in hypertensive COVID-19 patients yields better clinical outcomes.
- Subjects
UNITED States; ACE inhibitors; HYPERTENSION; ANGIOTENSIN II; ANGIOTENSIN receptors; ACUTE kidney failure; VIRAL pneumonia; COVID-19; RETROSPECTIVE studies; TREATMENT effectiveness; HOSPITAL care; EPIDEMICS
- Publication
Journal of Infectious Diseases, 2020, Vol 222, Issue 8, p1256
- ISSN
0022-1899
- Publication type
journal article
- DOI
10.1093/infdis/jiaa447