BACKGROUND: Data regarding the benefits or harm associated with the continuation of Angiotensin Converting Enzyme Inhibitors (ACEIs) and Angiotensin II Receptor Blockers (ARBs), especially the impact on inflammation, in hypertensive, hospitalized patients with COVID-19 in the United States is unclear. METHODS: This is a single-center cohort study of sequentially hospitalized patients with COVID-19 at Stony Brook University Medical Center from March 7, 2020 to April 1, 2020, inclusive of these dates. Data collection included history of known comorbidities, medications, vital signs and laboratory values (admission and during the hospitalization). Outcomes include inflammatory burden (composite scores for multiple markers of inflammation), acute kidney injury (AKI), admission to the intensive care unit (ICU), need for invasive mechanical ventilation, and mortality. RESULTS: Of the 300 patients in the study cohort, 80 patients (26.7%) had history of ACEI or ARB use prior to admission, with 61.3% (49/80) of these patients continuing the medications during hospitalization. Multivariable analysis revealed that the history of ACEI or ARB use prior to hospitalization was not associated with worse outcomes. In addition, the continuation of these agents during hospitalization was not associated with an increase in adverse outcomes and predicted fewer ICU admissions (OR=0.25, 0.08-0.81) with a decrease in the severity of inflammatory burden (peak CRP (6.9±3.1mg/dl, p=0.03) and peak inflammation score (2.3±1.1unit reduction, p=0.04)). CONCLUSION: Use of ACEI or ARBs prior to hospitalization was not associated with adverse outcomes in COVID-19 and the therapeutic benefits of continuing ACEI or ARB in hospitalized patients with COVID-19 was not offset by adverse outcomes.
BACKGROUND: Data regarding the benefits or harm associated with the continuation of Angiotensin Converting Enzyme Inhibitors (ACEIs) and Angiotensin II Receptor Blockers (ARBs), especially the impact on inflammation, in hypertensive, hospitalized patients with COVID-19 in the United States is unclear. METHODS: This is a single-center cohort study of sequentially hospitalized patients with COVID-19 at Stony Brook University Medical Center from March 7, 2020 to April 1, 2020, inclusive of these dates. Data collection included history of known comorbidities, medications, vital signs and laboratory values (admission and during the hospitalization). Outcomes include inflammatory burden (composite scores for multiple markers of inflammation), acute kidney injury (AKI), admission to the intensive care unit (ICU), need for invasive mechanical ventilation, and mortality. RESULTS: Of the 300 patients in the study cohort, 80 patients (26.7%) had history of ACEI or ARB use prior to admission, with 61.3% (49/80) of these patients continuing the medications during hospitalization. Multivariable analysis revealed that the history of ACEI or ARB use prior to hospitalization was not associated with worse outcomes. In addition, the continuation of these agents during hospitalization was not associated with an increase in adverse outcomes and predicted fewer ICU admissions (OR=0.25, 0.08-0.81) with a decrease in the severity of inflammatory burden (peak CRP (6.9±3.1mg/dl, p=0.03) and peak inflammation score (2.3±1.1unit reduction, p=0.04)). CONCLUSION: Use of ACEI or ARBs prior to hospitalization was not associated with adverse outcomes in COVID-19 and the therapeutic benefits of continuing ACEI or ARB in hospitalized patients with COVID-19 was not offset by adverse outcomes.
Authors: Joohae Kim; Sun Mi Choi; Jinwoo Lee; Young Sik Park; Chang Hoon Lee; Jae-Joon Yim; Chul-Gyu Yoo; Young Whan Kim; Sung Koo Han; Sang-Min Lee Journal: Korean J Crit Care Med Date: 2017-05-31
Authors: Christopher M Petrilli; Simon A Jones; Jie Yang; Harish Rajagopalan; Luke O'Donnell; Yelena Chernyak; Katie A Tobin; Robert J Cerfolio; Fritz Francois; Leora I Horwitz Journal: BMJ Date: 2020-05-22
Authors: Francisco J de Abajo; Sara Rodríguez-Martín; Victoria Lerma; Gina Mejía-Abril; Mónica Aguilar; Amelia García-Luque; Leonor Laredo; Olga Laosa; Gustavo A Centeno-Soto; Maria Ángeles Gálvez; Miguel Puerro; Esperanza González-Rojano; Laura Pedraza; Itziar de Pablo; Francisco Abad-Santos; Leocadio Rodríguez-Mañas; Miguel Gil; Aurelio Tobías; Antonio Rodríguez-Miguel; Diego Rodríguez-Puyol Journal: Lancet Date: 2020-05-14 Impact factor: 79.321
Authors: Terry Lee; Alessandro Cau; Matthew Pellan Cheng; Adeera Levin; Todd C Lee; Donald C Vinh; Francois Lamontagne; Joel Singer; Keith R Walley; Srinivas Murthy; David Patrick; Oleksa G Rewa; Brent W Winston; John Marshall; John Boyd; Karen Tran; Andre C Kalil; Russell Mcculoh; Robert Fowler; James M Luther; James A Russell Journal: CJC Open Date: 2021-04-06
Authors: Francisco J de Abajo; Antonio Rodríguez-Miguel; Sara Rodríguez-Martín; Victoria Lerma; Alberto García-Lledó Journal: BMC Med Date: 2021-05-12 Impact factor: 8.775
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