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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 renin-angiotensin system antagonists and severe outcomes of COVID-19. Patients should continue previous anti-hypertensive therapy until further evidence is available.

Original publication

DOI

10.1007/s11684-020-0800-y

Type

Journal article

Journal

Frontiers of medicine

Publication Date

10/2020

Volume

14

Pages

601 - 612

Addresses

Department of Basic Medical Sciences, Tsinghua University School of Medicine, Beijing, 100084, China.

Keywords

Humans, Pneumonia, Viral, Coronavirus Infections, Hypertension, Antihypertensive Agents, Angiotensin-Converting Enzyme Inhibitors, Severity of Illness Index, Hospital Mortality, Retrospective Studies, Comorbidity, Middle Aged, China, Female, Male, Angiotensin Receptor Antagonists, Pandemics, Betacoronavirus, Outcome and Process Assessment, Health Care, COVID-19, SARS-CoV-2