Intern Med J. 2020 Oct 6. doi: 10.1111/imj.15078. Online ahead of print.
BACKGROUND: Among hypertensive patients, the association between treatment with angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) and the clinical severity of Covid-19, remains uncertain.
AIMS: To determine whether hypertensive patients hospitalized with Covid-19 are at risk of worse outcomes if on treatment with ACEIs or ARBs compared to other anti-hypertensive medications.
METHODS: This is a retrospective study conducted at a single academic medical center [Fondazione Policlinico A.Gemelli IRCCS, Rome, Italy] from March 1st to 31 st , 2020. We compared patients on treatment with an ACEIs/ARBs (ACEIs/ARBs group) to patients receiving other anti-hypertensive medications (No-ACEIs/ARBs group). The endpoints of the study were the all-cause in-hospital death and the combination of in-hospital death or need for ICU admission.
RESULTS: The sample included 166 Covid-19 patients; median age was 74 years and 109 were men (66%). Overall, 111 patients (67%) were taking an ACEIs or ARBs. Twenty-nine patients (17%) died during hospital stay, and 51 (31%) met the combined endpoint. After adjustment for comorbidities, age and degree of severity at the presentation, ACEIs or ARBs treatment was an independent predictor neither of in-hospital death nor of the combination of in-hospital death/need for ICU. No differences were documented between treatment with ACEIs compared to ARBs.
CONCLUSIONS: Among hypertensive patients hospitalized for Covid-19, treatment with ACEIs or ARBs is not associated with an increased risk of in-hospital death. This article is protected by copyright. All rights reserved.