• Marcello Covino, Giuseppe De Matteis, Maria Livia Burzo, Michele Santoro, Mariella Fuorlo, Luca Sabia, Claudio Sandroni, Antonio Gasbarrini, Francesco Franceschi, Giovanni Gambassi, and Gemelli Against COVID-19 Group.
• Emergency Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
• Intern Med J. 2020 Dec 1; 50 (12): 148314911483-1491.

BackgroundAmong hypertensive patients, the association between treatment with angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II receptor blockers (ARB) and the clinical severity of COVID-19, remains uncertain.AimsTo determine whether hypertensive patients hospitalised with COVID-19 are at risk of worse outcomes if on treatment with ACEI or ARB compared to other anti-hypertensive medications.MethodsThis is a retrospective study conducted at a single academic medical centre (Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy) from 1 to 31 March 2020. We compared patients on treatment with an ACEI/ARB (ACEI/ARB group) to patients receiving other anti-hypertensive medications (No-ACEI/ARB group). The end-points of the study were the all-cause in-hospital death and the combination of in-hospital death or need for intensive care unit (ICU) admission.ResultsThe sample included 166 COVID-19 patients; median age was 74 years and 109 (66%) were men. Overall, 111 (67%) patients were taking an ACEI or ARB. Twenty-nine (17%) patients died during the hospital stay, and 51 (31%) met the combined end-point. After adjustment for comorbidities, age and degree of severity at the presentation, ACEI or ARB 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 ACEI compared to ARB.ConclusionsAmong hypertensive patients hospitalised for COVID-19, treatment with ACEI or ARB is not associated with an increased risk of in-hospital death.© 2020 Royal Australasian College of Physicians.

28 keywords...

hide…