• J. Infect. Dis. · Sep 2020

    Continued In-Hospital Angiotensin-Converting Enzyme Inhibitor and Angiotensin II Receptor Blocker Use in Hypertensive COVID-19 Patients Is Associated With Positive Clinical Outcome.

    • Katherine W Lam, Kenneth W Chow, Jonathan Vo, Wei Hou, Haifang Li, Paul S Richman, Sandeep K Mallipattu, Hal A Skopicki, Adam J Singer, and Tim Q Duong.
    • Department of Radiology, Renaissance School of Medicine, Stony Brook University, New York, New York, USA.
    • J. Infect. Dis. 2020 Sep 14; 222 (8): 1256-1264.

    BackgroundThis study investigated continued and discontinued use of angiotensin-converting enzyme inhibitors (ACEi) or angiotensin II receptor blockers (ARB) during hospitalization of 614 hypertensive laboratory-confirmed COVID-19 patients.MethodsDemographics, comorbidities, vital signs, laboratory data, and ACEi/ARB usage were analyzed. To account for confounders, patients were substratified by whether they developed hypotension and acute kidney injury (AKI) during the index hospitalization.ResultsMortality (22% vs 17%, P > .05) and intensive care unit (ICU) admission (26% vs 12%, P > .05) rates were not significantly different between non-ACEi/ARB and ACEi/ARB groups. However, patients who continued ACEi/ARBs in the hospital had a markedly lower ICU admission rate (12% vs 26%; P = .001; odds ratio [OR] = 0.347; 95% confidence interval [CI], .187-.643) and mortality rate (6% vs 28%; P = .001; OR = 0.215; 95% CI, .101-.455) compared to patients who discontinued ACEi/ARB. The odds ratio for mortality remained significantly lower after accounting for development of hypotension or AKI.ConclusionsThese findings suggest that continued ACEi/ARB use in hypertensive COVID-19 patients yields better clinical outcomes.© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

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