dc.creator | Pan M., Vasbinder A., Anderson E., Catalan T., Shadid H.R., Berlin H., Padalia K., O’hayer P., Meloche C., Azam T.U., Khaleel I., Michaud E., Blakely P., Bitar A., Huang Y., Zhao L., Pop-Busui R., Loosen S.H., Chalkias A., Tacke F., Giamarellos-Bourboulis E.J., Reiser J., Eugen-Olsen J., Hayek S.S. | en |
dc.date.accessioned | 2023-01-31T09:41:26Z | |
dc.date.available | 2023-01-31T09:41:26Z | |
dc.date.issued | 2021 | |
dc.identifier | 10.1161/JAHA.121.023535 | |
dc.identifier.issn | 20479980 | |
dc.identifier.uri | http://hdl.handle.net/11615/77444 | |
dc.description.abstract | BACKGROUND: Use of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers (ACEi/ARB) is thought to affect COVID-19 through modulating levels of angiotensin-converting enzyme 2, the cell entry receptor for SARS-CoV2. We sought to assess the association between ACEi/ARB, biomarkers of inflammation, and outcomes in patients hospitalized for COVID-19. METHODS AND RESULTS: We leveraged the ISIC (International Study of Inflammation in COVID-19), identified patients admitted for symptomatic COVID-19 between February 1, 2020 and June 1, 2021 for COVID-19, and examined the association between in-hospital ACEi/ARB use and all-cause death, need for ventilation, and need for dialysis. We estimated the causal effect of ACEi/ARB on the composite outcomes using marginal structural models accounting for serial blood pressure and serum creatinine measures. Of 2044 patients in ISIC, 1686 patients met inclusion criteria, of whom 398 (23.6%) patients who were previously on ACEi/ARB received at least 1 dose during their hospitalization for COVID-19. There were 215 deaths, 407 patients requiring mechanical ventilation, and 124 patients who required dialysis during their hospitalization. Prior ACEi/ARB use was associated with lower levels of soluble urokinase plasminogen activator receptor and C-reactive protein. In multivariable analysis, in-hospital ACEi/ARB use was associated with a lower risk of the composite outcome of in-hospital death, mechanical ventilation, or dialysis (adjusted hazard ratio 0.49, 95% CI [0.36– 0.65]). CONCLUSIONS: In patients hospitalized for COVID-19, ACEi/ARB use was associated with lower levels of inflammation and lower risk of in-hospital outcomes. Clinical trials will define the role of ACEi/ARB in the treatment of COVID-19. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04818866. © 2021 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. | en |
dc.language.iso | en | en |
dc.source | Journal of the American Heart Association | en |
dc.source.uri | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85122904185&doi=10.1161%2fJAHA.121.023535&partnerID=40&md5=0c6170895e79359461d562bfdbfb6563 | |
dc.subject | angiotensin receptor antagonist | en |
dc.subject | biological marker | en |
dc.subject | C reactive protein | en |
dc.subject | creatinine | en |
dc.subject | D dimer | en |
dc.subject | dipeptidyl carboxypeptidase inhibitor | en |
dc.subject | ferritin | en |
dc.subject | interleukin 6 | en |
dc.subject | lactate dehydrogenase | en |
dc.subject | procalcitonin | en |
dc.subject | urokinase receptor | en |
dc.subject | angiotensin receptor antagonist | en |
dc.subject | dipeptidyl carboxypeptidase inhibitor | en |
dc.subject | virus RNA | en |
dc.subject | adult | en |
dc.subject | aged | en |
dc.subject | all cause mortality | en |
dc.subject | Article | en |
dc.subject | artificial ventilation | en |
dc.subject | blood pressure | en |
dc.subject | confidence interval | en |
dc.subject | continuous renal replacement therapy | en |
dc.subject | controlled study | en |
dc.subject | coronavirus disease 2019 | en |
dc.subject | creatinine blood level | en |
dc.subject | female | en |
dc.subject | hazard ratio | en |
dc.subject | hospital admission | en |
dc.subject | hospital patient | en |
dc.subject | hospitalization | en |
dc.subject | human | en |
dc.subject | in-hospital mortality | en |
dc.subject | inflammation | en |
dc.subject | major clinical study | en |
dc.subject | male | en |
dc.subject | outcome assessment | en |
dc.subject | drug therapy | en |
dc.subject | hospital mortality | en |
dc.subject | hospitalization | en |
dc.subject | mortality | en |
dc.subject | retrospective study | en |
dc.subject | Angiotensin Receptor Antagonists | en |
dc.subject | Angiotensin-Converting Enzyme Inhibitors | en |
dc.subject | COVID-19 | en |
dc.subject | Hospital Mortality | en |
dc.subject | Hospitalization | en |
dc.subject | Humans | en |
dc.subject | Inflammation | en |
dc.subject | Retrospective Studies | en |
dc.subject | RNA, Viral | en |
dc.subject | American Heart Association Inc. | en |
dc.title | Angiotensin-Converting Enzyme Inhibitors, Angiotensin II Receptor Blockers, and Outcomes in Patients Hospitalized for COVID-19 | en |
dc.type | journalArticle | en |