Use of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers in context of COVID-19 outbreak: a
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RESEARCH ARTICLE
Use of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers in context of COVID-19 outbreak: a retrospective analysis Jiuyang Xu1,*, Chaolin Huang2,*, Guohui Fan3,4,5,*, Zhibo Liu3,4,*, Lianhan Shang3,4,6, Fei Zhou3,4, Yeming Wang3,4,7, Jiapei Yu1, Luning Yang1, Ke Xie3,7, Zhisheng Huang3,8, Lixue Huang3,7, Xiaoying Gu3,4,5, Hui Li3,4, Yi Zhang3,4,
Yimin Wang3,4, Frederick G. Hayden9, Peter W. Horby10, Bin Cao (✉)3,4,7,11, Chen Wang (✉)3,4,11,12
1
Department of Basic Medical Sciences, Tsinghua University School of Medicine, Beijing 100084, China; 2Department of Infectious Diseases, Jinyintan Hospital, Wuhan 430030, China; 3Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing 100029, China; 4Institute of Respiratory Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China; 5Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing 100029, China; 6Beijing University of Chinese Medicine, Beijing 100029, China; 7Department of Respiratory Medicine, Capital Medical University, Beijing 100029, China; 8Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China; 9Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA 22904, USA; 10Centre for Tropical Medicine and Global Health, University of Oxford, Oxford OX1 2JD, UK; 11Tsinghua University–Peking University Joint Center for Life Sciences, Beijing 100084, China; 12Chinese Academy of Engineering, Beijing 100088, China
© Higher Education Press 2020
Abstract The possible effects of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) on COVID-19 disease severity have generated considerable debate. We performed a single-center, retrospective analysis of hospitalized adult COVID-19 patients in Wuhan, China, who had definite clinical outcome (dead or discharged) by February 15, 2020. Patients on anti-hypertensive treatment with or without ACEI/ARB were compared on their clinical characteristics and outcomes. The medical records from 702 patients were screened. Among the 101 patients with a history of hypertension and taking at least one anti-hypertensive medication, 40 patients were receiving ACEI/ARB as part of their regimen, and 61 patients were on antihypertensive medication other than ACEI/ARB. We observed no statistically significant differences in percentages of in-hospital mortality (28% vs. 34%, P = 0.46), ICU admission (20% vs. 28%, P = 0.37) or invasive mechanical ventilation (18% vs. 26%, P = 0.31) between patients with or without ACEI/ARB treatment. Further multivariable adjustment of age and gender did not provide evidence for a significant association between ACEI/ARB treatment and severe COVID-19 outcomes. Our findings confirm the lack of an association between chronic receipt of reninangiotensin system antag
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