6533b854fe1ef96bd12af474
RESEARCH PRODUCT
Renin-angiotensin system inhibitors effect before and during hospitalization in COVID-19 outcomes: Final analysis of the international HOPE COVID-19 (Health Outcome Predictive Evaluation for COVID-19) registry
Martino PepeRodolfo RomeroFrancisco MarínÁLvaro López-masjuanJuan García-prietoMarcos García-aguadoJavier ElolaAntonio Fernández-ortizHope Covid InvestigatorsCarolina EspejoSergio Raposeiras-roubínVíctor Manuel Becerra-muñozChristoph LiebetrauIván OlierCarlos MacayaJorge Luis Jativa MendezCharbel Maroud EidElvira BondiaAlex F Castro-mejíaEnrico CerratoAdelina GonzalezJavier López-paisInmaculada Fernández-rozasAitor UribarriFabrizio UgoHarish RamakrishnaIván J. Núñez-gilMaría C Viana-llamasMohammad AbumayyalehMiguel Corbí-pascualGisela FeltesEmilio Alfonso-rodríguezVicente Estradasubject
QA75Malemedicine.medical_specialtyHeart diseaseInfecciones por coronavirusmedicine.medical_treatmentInhibidores enzimáticosPopulationClinical InvestigationsEnfermedad transmisibleAngiotensin-Converting Enzyme InhibitorsSistema renina-angiotensinaComorbidity030204 cardiovascular system & hematologySeverity of Illness Index03 medical and health sciences0302 clinical medicineRisk FactorsOutcome Assessment Health CareSeverity of illnessmedicineHumansRegistries030212 general & internal medicineMedical prescriptioneducationHeart FailureMechanical ventilationeducation.field_of_studySARS-CoV-2business.industryCOVID-19Middle AgedPrognosismedicine.diseaseR1Respiration ArtificialComorbidityHospitalizationItalySpainHeart failureEmergency medicineFemaleObservational studyCardiology and Cardiovascular Medicinebusinessdescription
Background The use of Renin-Angiotensin system inhibitors (RASi) in patients with coronavirus disease 2019 (COVID-19) has been questioned because both share a target receptor site. Methods HOPE-COVID-19 (NCT04334291) is an international investigator-initiated registry. Patients are eligible when discharged after an in-hospital stay with COVID-19, dead or alive. Here, we analyze the impact of previous and continued in-hospital treatment with RASi in all-cause mortality and the development of in-stay complications. Results We included 6503 patients, over 18 years, from Spain and Italy with data on their RASi status. Of those, 36.8% were receiving any RASi before admission. RASi patients were older, more frequently male, with more comorbidities and frailer. Their probability of death and ICU admission was higher. However, after adjustment, these differences disappeared. Regarding RASi in-hospital use, those who continued the treatment were younger, with balanced comorbidities but with less severe COVID19. Raw mortality and secondary events were less frequent in RASi. After adjustment, patients receiving RASi still presented significantly better outcomes, with less mortality, ICU admissions, respiratory insufficiency, need for mechanical ventilation or prone, sepsis, SIRS and renal failure (p<0.05 for all). However, we did not find differences regarding the hospital use of RASi and the development of heart failure. Conclusion RASi historic use, at admission, is not related to an adjusted worse prognosis in hospitalized COVID-19 patients, although it points out a high-risk population. In this setting, the in-hospital prescription of RASi is associated with improved survival and fewer short-term complications. Sin financiación 5.099 JCR (2021) Q2, 50/143 Cardiac & Cardiovascular Systems 2.564 SJR (2021) Q1, 18/356 Cardiology and Cardiovascular Medicine No data IDR 2021 UEM
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2021-01-01 | American Heart Journal |