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COVID-19 Pandemic Waves and 2024-2025 Winter Season in Relation to Angiotensin-Converting Enzyme Inhibitors,

Anna Puigdellívol-Sánchez1,2, Marta Juanes-González1, Ana Isabel Calderón-Valdiviezo1

  • 1Medicina de Familia, CAP Anton de Borja-Centre Universitari, c/Marconi-Cantonada Edison s/n, Consorci Sanitari de Terrassa (CST), 08191 Rubí, Spain.

Healthcare (Basel, Switzerland)
|June 13, 2025
PubMed

Insights

Angiotensin-converting enzyme inhibitors (ACEI), ARBs, and amantadine may protect against severe COVID-19. These medications appear safe for continued use in hypertensive patients, though further research is needed.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Pharmacology

Background:

  • Early COVID-19 reports suggested better outcomes for hypertensive patients on ACEI or amantadine.
  • This study investigates the impact of these medications on COVID-19 disease progression.

Purpose of the Study:

  • To evaluate the impact of ACEI, ARBs, and amantadine on COVID-19 outcomes.
  • To assess the safety and efficacy of continuing these medications during the pandemic.

Main Methods:

  • Analysis of 55,936 COVID-19 patients and 2024 hospital admissions from March 2020 to January 2025.
  • Comparison of hospitalizations, ICU admissions, and length of stay across different COVID-19 waves and polypharmacy levels.
  • Chi-square tests used to compare hospitalization rates stratified by polypharmacy.

Main Results:

  • Non-survivors were predominantly older adults (>60 or >70 years) across waves.
  • Post-vaccination, mortality decreased, but hospitalizations in younger patients increased during the Delta wave.
  • ACEI/ARB-treated patients showed reduced hospitalizations (OR 1.21-4.26 for ACEI, OR 1.24-1.74 for ARB).
  • No hospitalizations were observed in amantadine-treated patients under 70.

Conclusions:

  • ACEI, ARBs, and amantadine may offer protection against severe COVID-19.
  • These medications appear safe for continued use in hypertensive patients during the pandemic.
  • Further multicentric studies are recommended to validate findings, especially regarding post-COVID syndrome.

Keywords:
ACE inhibitorsCOVID-19amantadineangiotensin receptor blockers

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