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RESEARCH PRODUCT

Renin-Angiotensin System Blockade and Mortality in Patients With Hypertension and COVID-19 Infection

Husam M. SalahJawahar L. MehtaGuisseppe Calcaterra

subject

medicine.medical_specialtyhypertensionCoronavirus disease 2019 (COVID-19)PopulationPneumonia ViralAngiotensin-Converting Enzyme Inhibitors030204 cardiovascular system & hematologyCochrane LibraryGastroenterologyArticleRenin-Angiotensin System03 medical and health sciencesAngiotensin Receptor AntagonistsBetacoronavirus0302 clinical medicineInternal medicineRenin–angiotensin systemmedicineHumansPharmacology (medical)In patient030212 general & internal medicineeducationPandemicsPharmacologyeducation.field_of_studybiologybusiness.industrySARS-CoV-2Mortality rateCOVID-19Angiotensin-converting enzymerenin-angiotensin-aldosterone systemRelative riskbiology.proteinCardiology and Cardiovascular MedicinebusinessCoronavirus InfectionsAngiotensin II Type 1 Receptor Blockers

description

To determine the effect renin-angiotensin system blockers on the outcome in patients with hypertension and concurrent COVID-19 infection, we searched PubMed, the Cochrane Library, and Google Scholar for relevant articles. Twelve studies with a total of 16,101 patients met the inclusion criteria. The mortality rate among the users of angiotensin converting enzyme inhibitors or angiotensin receptor blockers was 12.15% and in non-users it was 14.56% (risk ratio 0.70, 95% CI [0.53-0.91], P < 0.007). There was no difference in the risk of death between the use of angiotensin converting enzyme inhibitors and angiotensin receptor blockers (risk ratio 1.09, 95% CI [0.90 -1.32]). We conclude that the use of angiotensin converting enzyme inhibitors and angiotensin receptor blockers improves mortality in patients with hypertension and concurrent COVID-19 infection, without a significant difference between ACEIs and ARBs in this population.

10.1177/1074248420947628http://europepmc.org/articles/PMC7404086