Title:
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Association of renin-angiotensin system blockers with COVID-19 diagnosis and prognosis in patients with hypertension : a population-based study
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Author:
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Soler, María José; Ribera, A; Marsal, Josep Ramon; Méndez, Ana Belen; Andrés Villareal, Mireia; Azancot, María A; Oristrell, Gerard; Méndez-Boo, Leonardo; Cohen, Jordana; Barrabés, José A; Ferreira-Gonzalez, Ignacio; Universitat Autònoma de Barcelona
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Abstract:
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The effect of renin-angiotensin system (RAS) blockade either by angiotensin-converting enzyme inhibitors (ACEis) or angiotensin-receptor blockers (ARBs) on coronavirus disease 2019 (COVID-19) susceptibility, mortality and severity is inadequately described. We examined the association between RAS blockade and COVID-19 diagnosis and prognosis in a large population-based cohort of patients with hypertension (HTN). This is a cohort study using regional health records. We identified all individuals aged 18-95 years from 87 healthcare reference areas of the main health provider in Catalonia (Spain), with a history of HTN from primary care records. Data were linked to COVID-19 test results, hospital, pharmacy and mortality records from 1 March 2020 to 14 August 2020. We defined exposure to RAS blockers as the dispensation of ACEi/ARBs during the 3 months before COVID-19 diagnosis or 1 March 2020. Primary outcomes were: COVID-19 infection and severe progression in hospitalized patients with COVID-19 (the composite of need for invasive respiratory support or death). For both outcomes and for each exposure of interest (RAS blockade, ACEi or ARB) we estimated associations in age-, sex-, healthcare area- and propensity score-matched samples. From a cohort of 1 365 215 inhabitants we identified 305 972 patients with HTN history. Recent use of ACEi/ARBs in patients with HTN was associated with a lower 6-month cumulative incidence of COVID-19 diagnosis {3.78% [95% confidence interval (CI) 3.69-3.86%] versus 4.53% (95% CI 4.40-4.65%); P < 0.001}. In the 12 344 patients with COVID-19 infection, the use of ACEi/ARBs was not associated with a higher risk of hospitalization with need for invasive respiratory support or death [OR = 0.91 (0.71-1.15); P = 0.426]. RAS blockade in patients with HTN is not associated with higher risk of COVID-19 infection or with a worse progression of the disease |
Subject(s):
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-Angiotensin-converting enzyme -Angiotensin receptor blockers -COVID-19 -Hypertension -Mortality -Renin-angiotensin system blockers |
Rights:
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open access
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https://creativecommons.org/licenses/by-nc/4.0/ |
Document type:
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Article |
Published by:
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Uri:
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https://ddd.uab.cat/record/252188
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