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Effects of ACEI and ARB on COVID-19 patients: A meta-analysis

Yang Xue1, Shaoqing Sun2, Jianing Cai2

  • 1Department of Respiratory Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.

Journal of the Renin-Angiotensin-Aldosterone System : JRAAS
|December 16, 2020
PubMed

Insights

Angiotensin-converting enzyme inhibitors (ACEI) and angiotensin-receptor blockers (ARB) may reduce fever and D-dimer levels in COVID-19 patients. However, these drugs showed no significant impact on other symptoms or lab tests, except for a potential rise in creatinine.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Clinical use of ACEI/ARB in COVID-19 patients is debated.
  • Hypertension management during COVID-19 requires clarity on ACEI/ARB effects.

Purpose of the Study:

  • To meta-analyze the impact of ACEI/ARB on COVID-19 symptoms and lab tests.
  • To compare outcomes in hypertensive COVID-19 patients on ACEI/ARB versus those not on these drugs.

Main Methods:

  • Systematic literature search across major databases (PubMed, Embase, etc.).
  • Meta-analysis of six studies involving 1808 hypertensive COVID-19 patients.
  • Statistical analysis performed using REVMAN5.3 software.

Main Results:

  • ACEI/ARB use was associated with lower D-dimer levels (SMD = -0.22) and reduced fever incidence (OR = 0.74).
  • No significant differences in most laboratory tests or symptoms were observed.
  • Creatinine levels showed a tendency to increase (SMD = 0.22).

Conclusions:

  • ACEI/ARB administration positively impacts D-dimer and fever in COVID-19 patients.
  • No significant effect on other lab tests (except creatinine) or symptoms.
  • Caution is advised for COVID-19 patients with renal insufficiency on ACEI/ARB.
Abstract

Keywords:
ACEIARBCOVID-19hypertensionmeta analysis

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