Gary Tse1, Jiandong Zhou2, Sharen Lee3, Wing Tak Wong4, Xintao Li5, Tong Liu1, Zhidong Cao6, Daniel Dajun Zeng6, Abraham K C Wai7, Ian Chi Kei Wong8, Bernard Man Yung Cheung9, Qingpeng Zhang2. 1. Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin. 2. School of Data Science, City University of Hong Kong, Hong Kong. 3. Laboratory of Cardiovascular Physiology, Li Ka Shing Institute of Health Sciences. 4. School of Life Sciences, The Chinese University of Hong Kong, Hong Kong. 5. Department of Cardiology, The First People's Hospital of Changzhou, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu. 6. Institute of Automation, Chinese Academy of Sciences, Beijing. 7. Emergency Medicine Unit, Li Ka Shing Faculty of Medicine. 8. Department of Pharmacology and Pharmacy. 9. Division of Clinical Pharmacology and Therapeutics, Department of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China.
Abstract
BACKGROUND: Angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) may be associated with higher susceptibility of COVID-19 infection and adverse outcomes. We compared ACEI/ARB use and COVID-19 positivity in a case-control design, and severity in COVID-19 positive patients. METHODS: Consecutive patients who attended Hong Kong's public hospitals or outpatient clinics between 1 January and 28 July 2020 for COVID-19 real time-PCR (RT-PCR) tests were included. Baseline demographics, past comorbidities, laboratory tests and use of different medications were compared between COVID-19 positive and negative patients. Severe endpoints for COVID-19 positive patients were 28-day mortality, need for intensive care admission or intubation. RESULTS: This study included 213 788 patients (COVID-19 positive: n = 2774 patients; negative: n = 211 014). In total, 162 COVID-19 positive patients (5.83%) met the severity outcome. The use of ACEI/ARB was significantly higher amongst cases than controls (n = 156/2774, 5.62 vs. n = 6708/211014, 3.17%; P < 0.0001). Significant univariate predictors of COVID-19 positivity and severe COVID-19 disease were older age, higher Charlson score, comorbidities, use of ACEI/ARB, antidiabetic, lipid-lowering, anticoagulant and antiplatelet drugs and laboratory tests (odds ratio >1, P < 0.05). The relationship between the use of ACEI/ARB and COVID-19 positivity or severe disease remained significant after multivariable adjustment. No significant differences in COVID-19 positivity or disease severity between ACEI and ARB use were observed (P > 0.05). CONCLUSION: There was a significant relationship between ACEI/ARB use and COVID-19 positivity and severe disease after adjusting for significant confounders.
BACKGROUND:Angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) may be associated with higher susceptibility of COVID-19infection and adverse outcomes. We compared ACEI/ARB use and COVID-19 positivity in a case-control design, and severity in COVID-19 positive patients. METHODS: Consecutive patients who attended Hong Kong's public hospitals or outpatient clinics between 1 January and 28 July 2020 for COVID-19 real time-PCR (RT-PCR) tests were included. Baseline demographics, past comorbidities, laboratory tests and use of different medications were compared between COVID-19 positive and negative patients. Severe endpoints for COVID-19 positive patients were 28-day mortality, need for intensive care admission or intubation. RESULTS: This study included 213 788 patients (COVID-19 positive: n = 2774 patients; negative: n = 211 014). In total, 162 COVID-19 positive patients (5.83%) met the severity outcome. The use of ACEI/ARB was significantly higher amongst cases than controls (n = 156/2774, 5.62 vs. n = 6708/211014, 3.17%; P < 0.0001). Significant univariate predictors of COVID-19 positivity and severe COVID-19 disease were older age, higher Charlson score, comorbidities, use of ACEI/ARB, antidiabetic, lipid-lowering, anticoagulant and antiplatelet drugs and laboratory tests (odds ratio >1, P < 0.05). The relationship between the use of ACEI/ARB and COVID-19 positivity or severe disease remained significant after multivariable adjustment. No significant differences in COVID-19 positivity or disease severity between ACEI and ARB use were observed (P > 0.05). CONCLUSION: There was a significant relationship between ACEI/ARB use and COVID-19 positivity and severe disease after adjusting for significant confounders.
Authors: Steven M Smith; Raj A Desai; Marta G Walsh; Ester Kim Nilles; Katie Shaw; Myra Smith; Alanna M Chamberlain; Catherine G Derington; Adam P Bress; Cynthia H Chuang; Daniel E Ford; Bradley W Taylor; Sravani Chandaka; Lav Parshottambhai Patel; James McClay; Elisa Priest; Jyotsna Fuloria; Kruti Doshi; Faraz S Ahmad; Anthony J Viera; Madelaine Faulkner; Emily C O'Brien; Mark J Pletcher; Rhonda M Cooper-DeHoff Journal: Am Heart J Plus Date: 2022-03-02
Authors: Jiandong Zhou; Sharen Lee; Ishan Lakhani; Lei Yang; Tong Liu; Yuhui Zhang; Yunlong Xia; Wing Tak Wong; Kelvin King Hei Bao; Ian Chi Kei Wong; Gary Tse; Qingpeng Zhang Journal: Cardiooncology Date: 2022-03-17
Authors: Oscar Hou In Chou; Jiandong Zhou; Teddy Tai Loy Lee; Thompson Kot; Sharen Lee; Abraham Ka Chung Wai; Wing Tak Wong; Qingpeng Zhang; Shuk Han Cheng; Tong Liu; Vassilios S Vassiliou; Bernard Man Yung Cheung; Gary Tse Journal: Clin Res Cardiol Date: 2022-03-25 Impact factor: 6.138