Continued In-Hospital Angiotensin-Converting Enzyme Inhibitor and Angiotensin II Receptor Blocker Use in Hypertensive...

Area of Science:

• Cardiology
• Infectious Diseases
• Pharmacology

Background:

• Hypertension management is crucial, especially during viral infections like COVID-19.
• Angiotensin-converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB) are commonly used antihypertensives.
• The impact of continuing or discontinuing ACEi/ARB during COVID-19 hospitalization remains an area of investigation.

Purpose of the Study:

• To investigate the association between continued versus discontinued use of ACEi or ARB and clinical outcomes in hypertensive patients with COVID-19.
• To determine if ACEi/ARB use influences mortality and intensive care unit (ICU) admission rates during hospitalization.

Main Methods:

• Retrospective analysis of 614 hypertensive patients with laboratory-confirmed COVID-19.
• Patients were categorized based on the continuation or discontinuation of ACEi/ARB therapy during hospitalization.
• Substratification was performed to account for the development of hypotension and acute kidney injury (AKI).

Main Results:

• Patients who continued ACEi/ARB therapy during hospitalization showed significantly lower ICU admission rates (12% vs. 26%) and mortality rates (6% vs. 28%) compared to those who discontinued.
• The reduced odds of mortality persisted even after adjusting for hypotension and AKI.
• No significant difference in mortality or ICU admission was observed between patients who never used ACEi/ARB and those who discontinued the medication.

Conclusions:

• Continued use of ACEi/ARB in hypertensive patients hospitalized with COVID-19 is associated with improved clinical outcomes.
• Discontinuation of ACEi/ARB during COVID-19 hospitalization may be linked to poorer outcomes.
• These findings support the continuation of ACEi/ARB therapy in hypertensive patients diagnosed with COVID-19.