Renin–Angiotensin–Aldosterone System Inhibitors and Risk of Covid-19
By H. Reynolds, S. Adhikari, C. Pulgarin, Andrea B. Troxel, Eduardo Iturrate, Stephen B. Johnson, A. Hausvater, J. Newman, J. Berger, S. Bangalore and 6 more. New England Journal of Medicine, 2020
921 citations recorded by the source corpus.
Abstract Background There is concern about the potential of an increased risk related to medications that act on the renin–angiotensin–aldosterone system in patients exposed to coronavirus disease 2019 (Covid-19), because the viral receptor is angiotensin-converting enzyme 2 (ACE2). Methods We assessed the relation between previous treatment with ACE inhibitors, angiotensin-receptor blockers, beta-blockers, calcium-channel blockers, or thiazide diuretics and the likelihood of a positive or negative result on Covid-19 testing as well as the likelihood of severe illness (defined as intensive care, mechanical ventilation, or death) among patients who tested positive. Using Bayesian methods, we compared outcomes in patients who had been treated with these medications and in untreated patients, overall and in those with hypertension, after propensity-score matching for receipt of each medication class. A difference of at least 10 percentage points was prespecified as a substantial difference. Results Among 12,594 patients who were tested for Covid-19, a total of 5894 (46.8%) were positive; 1002 of these patients (17.0%) had severe illness. A history of hypertension was present in 4357 patients (34.6%), among whom 2573 (59.1%) had a positive test; 634 of these patients (24.6%) had severe illness. There was no association between any single medication class and an increased likelihood of a positive test. None of the medications examined was associated with a substantial increase in the risk of severe illness among patients who tested positive. Conclusions We found no substantial increase in the likelihood of a positive test for Covid-19 or in the risk of severe Covid-19 among patients who tested positive in association with five common classes of antihypertensive medications.
Subfields: Cardiology and Cardiovascular Medicine, Infectious Diseases, Neurology
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In Cardiology and Cardiovascular Medicine
Citations in the corpus
- Prevalence and Impact of Myocardial Injury in Patients Hospitalized With COVID-19 Infection (2020, positive): “Because SARS-CoV-2 enters cells via binding to the ACE2 receptor, previous concerns existed as to increased risk of adverse outcomes conferred by ACE inhibitors or ARBs; these worries have been somewhat dissipated in light of recent studies showing no increased risk associated with the use of these ”