6533b82efe1ef96bd1293470
RESEARCH PRODUCT
RAAS inhibitors are not associated with mortality in COVID-19 patients: Findings from an observational multicenter study in Italy and a meta-analysis of 19 studies
Francesca SantilliMarianna MeschiariGabriella GuarnieriFrancesco PetriAnna SabenaGloria MaccagniGiovanni LarizzaMassimo MapelliMaria MazzitelliGian Battista DanziKatleen De Gaetano DonatiAnnalisa CrisettiJovana MilicRaffaele PesaventoBiagio PincheraRiccardo MaragnaCarlo Andrea PivatoLorenzo MenicantiFrancesco Maria FuscoLuca AielloSandro MancarellaCarlo SanroccoAlessandra VergoriGreta BarbieriFilippo AucellaSilvia MarongiuGiulio MarescaMarianna RossiAndrea AntinoriVenerino PolettiFrancesco CacciatoreGiacomo CastiglioneEnrico Maria TrecarichiLucia CaianoFrancesca CrostaRoberto VettorFrancesco MenichettiMaria MussoSalinaro FrancescoMarco OlivieriStefano PerliniClaudia ColombaCrizia ColomboOttavia CozziStefano MaitanMarialaura BonaccioIlaria MyAlexandra ViranoPaola SimeoneMarco VincetiMarco VincetiAntonella CingolaniGianpiero D'offiziDamiano D'ardesClaudia MarottaM. B. LuciaCarlo SignorelliLorenzo MarraGiuseppe PattiRaffaele De CaterinaArmando LeoneVeronica LioBeatrice MolenaGiustino ParrutiGiulio G. StefaniniLicia IacovielloLaura VoccianteFranco MastroianniRaffaella SgarigliaCristina MussiniFrancesco CipolloneMarco RossatoLorenzo BlandiEmanuela PasiSamir Al MoghaziAndrea VianelloFilippo MinutoloIvan GentileGiovanni GuaraldiRosa ManuelePasquale AbeteArturo CicculloAntonella PalimoddeGiancarlo ScoppettuoloWalter AgenoMarco G. MennuniRoberta MussinelliVincenzo SangiovanniRoberto CaudaLaura ScorzoliniPaolo BonfantiAlessandro GialluisiStefania CianfronePiergiuseppe AgostoniAntonio CascioSimona CostanzoAugusto Di CastelnuovoNausicaa BerselliRosa ArborettiEmauele GrazianiMartina BarchittaAnna OdoneFrancesco Di GennaroAlessandro MengozziAlessandro BartoloniGiuseppe Di TanoLaura CarrozziFerruccio MadaroRossella MarcucciClaudia Ravagliasubject
0301 basic medicineMalePhysiologyMiddle Aged Renin-Angiotensin SystemAngiotensin-Converting Enzyme Inhibitors030204 cardiovascular system & hematologyACE-I; ARB; COVID-19; angiotensin converting enzyme inhibitors; angiotensin receptor blockers; mortality; sartansSeverity of Illness IndexRenin-Angiotensin System0302 clinical medicineangiotensin converting enzyme inhibitorsRisk FactorsACE-I80 and overMedicineHospital MortalitySartanAged 80 and overIncidence (epidemiology)IncidenceHazard ratioAngiotensin Receptor AntagonistMiddle AgedsartansARBHospitalizationAntihypertensive AgentItalyMeta-analysisHypertensionSartansMolecular MedicineFemaleRisk assessmentHumanmedicine.medical_specialtyAngiotensin converting enzyme inhibitors; ACE-I; Angiotensin receptor blockers; ARB; Sartans; COVID-19; MortalityCoronavirus disease 2019 (COVID-19)Risk AssessmentArticleCOVID−1903 medical and health sciencesAngiotensin Receptor AntagonistsMeta-Analysis as TopicInternal medicineSeverity of illnessHumansAngiotensin receptor blockerMortalityAntihypertensive AgentsAgedPharmacologyACE-I; ARB; Angiotensin converting enzyme inhibitors; Angiotensin receptor blockers; COVID−19; Mortality; Sartans; Aged; Aged 80 and over; Angiotensin Receptor Antagonists; Angiotensin-Converting Enzyme Inhibitors; Antihypertensive Agents; COVID-19; Female; Hospitalization; Humans; Hypertension; Incidence; Italy; Male; Meta-Analysis as Topic; Middle Aged; Renin-Angiotensin System; Risk Assessment; Risk Factors; Severity of Illness Index; Hospital Mortalitybusiness.industryRisk FactorCOVID-19Angiotensin-Converting Enzyme InhibitorAngiotensin receptor blockersmortalityConfidence intervalangiotensin receptor blockersAngiotensin converting enzyme inhibitors030104 developmental biologyACE-I; ARB; COVID-19 angiotensin converting enzyme inhibitors angiotensin receptor blockers mortality sartansObservational studyAngiotensin converting enzyme inhibitorbusinessdescription
Abstract Objective The hypothesis that been set forward that use of Renin Angiotensin Aldosterone System (RAAS) inhibitors is associated with COVID−19 severity. We set-up a multicenter Italian collaboration (CORIST Project, ClinicalTrials.gov ID: NCT04318418 ) to retrospectively investigate the relationship between RAAS inhibitors and COVID−19 in-hospital mortality. We also carried out an updated meta-analysis on the relevant studies. Methods We analyzed 4069 unselected patients with laboratory-confirmed SARS-CoV-2 infection and hospitalized in 34 clinical centers in Italy from February 19, 2020 to May 23, 2020. The primary end-point in a time-to event analysis was in-hospital death, comparing patients who received angiotensin-converting–enzyme inhibitors (ACE I) or angiotensin-receptor blockers (ARB) with patients who did not. Articles for the meta-analysis were retrieved until July 13th, 2020 by searching in web-based libraries, and data were combined using the general variance-based method. Results Out of 4069 COVID−19 patients, 13.5% and 13.3% received ACE-I or ARB, respectively. Use of neither ACE-I nor ARB was associated with mortality (multivariable hazard ratio (HR) adjusted also for COVID−19 treatments: 0.96, 95% confidence interval 0.77–1.20 and HR = 0.89, 0.67–1.19 for ACE-I and ARB, respectively). Findings were similar restricting the analysis to hypertensive (N = 2057) patients (HR = 1.00, 0.78–1.26 and HR = 0.88, 0.65–1.20) or when ACE-I or ARB were considered as a single group. Results from the meta-analysis (19 studies, 29,057 COVID−19 adult patients, 9700 with hypertension) confirmed the absence of association. Conclusions In this observational study and meta-analysis of the literature, ACE-I or ARB use was not associated with severity or in-hospital mortality in COVID−19 patients.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2020-01-01 |