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Angiotensin Converting Enzyme Inhibitor and Angiotensin II Receptor Blocker Use Among Outpatients Diagnosed With
David J Bae1, David M Tehrani1, Soniya V Rabadia2
1Division of Cardiology, University of California, Los Angeles, California.
The American Journal of Cardiology
|August 22, 2020
Summary
Use of angiotensin converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARB) did not increase hospital admission risk for patients with COVID-19. This study found no significant difference in mortality or critical care needs between users and non-users.
Area of Science:
- Cardiology
- Infectious Diseases
- Pharmacology
Background:
- Coronavirus disease 2019 (COVID-19) is a global pandemic caused by SARS-CoV-2.
- Concerns exist regarding ACEI/ARB use potentially worsening COVID-19 outcomes due to their role in the renin-angiotensin system.
- ACEI/ARB are commonly prescribed for cardiovascular conditions like hypertension and heart failure.
Purpose of the Study:
- To investigate the association between ACEI/ARB use and hospital admission in COVID-19 patients.
- To evaluate the impact of ACEI/ARB on secondary outcomes including ICU admission, mechanical ventilation, and mortality.
Main Methods:
- Retrospective, single-center US study involving adult COVID-19 patients.
- Propensity score matching was employed to control for confounding factors.
- Multivariate logistic regression analyzed the association between ACEI/ARB use and hospital admission, adjusting for covariates.
Main Results:
- In the propensity-matched cohort, ACEI/ARB use was not significantly associated with hospital admission (OR 1.2, 95%CI 0.5-2.7, p=0.652).
- Coronary artery disease (CAD) and chronic kidney disease/end-stage renal disease (CKD/ESRD) were independently linked to hospital admission.
- No significant differences were observed in all-cause mortality, ICU stay, mechanical ventilation, or inotrope use between ACEI/ARB users and non-users.
Conclusions:
- ACEI/ARB use is not associated with an increased risk of hospital admission in patients diagnosed with COVID-19.
- Comorbidities like CAD and CKD/ESRD remain significant predictors of hospital admission in COVID-19 patients.
- Current evidence suggests that ACEI/ARB therapy can be safely continued in patients with COVID-19.
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