Effects of angiotensin receptor blockers (ARBs) on clinical outcomes of patients with hypertension and COVID-19: A 7-month follow-up cohort study.

IF 1.2 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Cardiovascular and Thoracic Research Pub Date : 2022-01-01 DOI:10.34172/jcvtr.2022.30559
Azar Hadadi, Sina Kazemian, Mahan Shafie, Arezoo Ahmadi, Abbas Soleimani, Haleh Ashraf
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Abstract

Introduction: Since the coronavirus disease 2019 (COVID-19) pandemic, the use of angiotensin II receptor blockers (ARBs) in hypertensive patients with COVID-19 has been controversial. Following our previous study, after one year, we intended to extend our sample size and results to investigate the effects of ARBs with both in-hospital outcomes and 7-month follow-up results in patients with COVID-19. Methods: Patients with a diagnosis of COVID-19 who were admitted to Sina Hospital, Tehran, Iran, from February to October 2020 participated in this follow-up cohort study. The COVID-19 diagnosis was based on a positive polymerase chain reaction test or chest computed tomography scan according to guidelines. Patients were followed for disease severity, incurring in-hospital mortality, complications, and 7-month all-cause mortality. Results: We evaluated 1413 patients with COVID-19 in this study. After excluding 124 patients, 1289 including 561(43.5%) hypertensive patients, entered the analysis. During the study, 875(67.9%) severe disease, 227(17.6%) in-hospital mortality, and 307(23.8%) 7-month all-cause mortality were observed. After adjusting for possible confounders, ARB was not associated with severity, in-hospital and 7-month all-cause mortality, and in-hospital complications except for acute kidney injury. Discontinuation of ARBs was significantly associated with higher in-hospital mortality and 7-month all-cause mortality (both P values<0.006). We observed a better 7-month outcome in those who continued their ARBs after discharge. Conclusion: The results of this study, along with the previous studies, provide reassurance that taking ARBs is not associated with the risk of mortality, complications, and poorer outcomes in hypertensive COVID-19 patients after adjustment for possible confounders.

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血管紧张素受体阻滞剂(ARBs)对高血压合并COVID-19患者临床结局的影响:一项7个月的随访队列研究
自2019冠状病毒病(COVID-19)大流行以来,血管紧张素II受体阻滞剂(ARBs)在高血压COVID-19患者中的应用一直存在争议。在我们之前的研究之后,一年后,我们打算扩大我们的样本量和结果,以调查arb对COVID-19患者住院结局和7个月随访结果的影响。方法:选取2020年2月至10月在伊朗德黑兰新浪医院收治的确诊为COVID-19的患者进行随访队列研究。新冠肺炎诊断依据是聚合酶链反应试验阳性或胸部计算机断层扫描。随访患者的疾病严重程度、住院死亡率、并发症和7个月全因死亡率。结果:本研究评估了1413例COVID-19患者。在排除124例患者后,1289例,其中561例(43.5%)高血压患者进入分析。研究期间共发生重症病例875例(67.9%),住院死亡227例(17.6%),7个月全因死亡307例(23.8%)。在调整了可能的混杂因素后,ARB与严重程度、住院和7个月全因死亡率以及除急性肾损伤外的住院并发症无关。结论:本研究和之前的研究结果再次证明,在调整了可能的混杂因素后,服用arb与高血压COVID-19患者的死亡率、并发症和较差结局的风险无关。
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来源期刊
Journal of Cardiovascular and Thoracic Research
Journal of Cardiovascular and Thoracic Research CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
2.00
自引率
0.00%
发文量
22
审稿时长
7 weeks
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