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Different therapeutic associations of renin-angiotensin system inhibitors with coronavirus disease 2019 compared with usual pneumonia

Title
Different therapeutic associations of renin-angiotensin system inhibitors with coronavirus disease 2019 compared with usual pneumonia
Authors
Lee H.-Y.Ahn J.Park J.Kang C.K.Won S.-H.Kim D.W.Park J.-H.Chung K.-H.Joh J.-S.Bang J.I.H.Kang C.H.Oh M.-D.Pyun W.B.The Korean Society of HypertensionThe National Committee for Clinical Management of Emerging Infectious Diseases
Ewha Authors
편욱범
SCOPUS Author ID
편욱범scopus
Issue Date
2021
Journal Title
Korean Journal of Internal Medicine
ISSN
1226-3303JCR Link
Citation
Korean Journal of Internal Medicine vol. 36, no. 3, pp. 617 - 628
Keywords
Angiotensin receptor antagonistsAngiotensin-converting enzyme inhibitorsCOVID-19MortalityPneumonia
Publisher
Korean Association of Internal Medicine
Indexed
SCIE; SCOPUS; KCI WOS scopus
Document Type
Article
Abstract
Background/Aims: Although it is near concluded that renin-angiotensin system inhibitors do not have a harmful effect on coronavirus disease 2019 (COVID-19), there is no report about whether angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEIs) offer any protective role. This study aimed to compare the association of ARBs and ACEIs with COVID-19-related mortality. Methods: All patients with COVID-19 in Korea between January 19 and April 16, 2020 were enrolled. The association of ARBs and ACEIs with mortality within 60 days were evaluated. A comparison of hazard ratio (HR) was performed between COVID-19 patients and a retrospective cohort of pneumonia patients hospitalized in 2019 in Korea. Results: Among 10,448 COVID-19 patients, ARBs and ACEIs were prescribed in 1,231 (11.7%) and 57 (0.6%) patients, respectively. After adjusting for age, sex, and history of comorbidities, the ARB group showed neutral association (HR, 1.034; 95% CI, 0.765 to 1.399; p = 0.8270) and the ACEI groups showed no significant associations likely owing to the small population size (HR, 0.736; 95% CI, 0.314 to 1.726; p = 0.4810). When comparing HR between COVID-19 patients and a retrospective cohort of patients hospitalized with pneumonia in 2019, the trend of ACEIs showed similar benefits, whereas the protective effect of ARBs observed in the retrospective cohort was absent in COVID-19 patients. Meta-analyses showed significant positive correlation with survival of ACEIs, whereas a neutral association between ARBs and mortality. Conclusions: Although ARBs or ACEIs were not associated with fatal outcomes, potential beneficial effects of ARBs observed in pneumonia were attenuated in COVID-19. © 2021 The Korean Association of Internal Medicine.
DOI
10.3904/KJIM.2020.656
Appears in Collections:
의과대학 > 의학과 > Journal papers
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