Effect of Renin-Angiotensin-Aldosterone System Inhibitors in Patients with COVID-19: a Systematic Review and Meta-analysis of 28,872 Patients.
Ranu BaralMadeline WhiteVassilios S VassiliouPublished in: Current atherosclerosis reports (2020)
A total of 28,872 patients were included in this meta-analysis. The use of any RAAS inhibition for any conditions showed a trend to lower risk of death/critical events (OR 0.671, CI 0.435 to 1.034, p = 0.071). Within the hypertensive cohort, however, there was a significant lower association with deaths (OR 0.664, CI 0.458 to 0.964, p = 0.031) or the combination of death/critical outcomes (OR 0.670, CI 0.495 to 0.908, p = 0.010). There was no significant association of critical/death outcomes within ACEi vs non-ACEi (OR 1.008, CI 0.822 to 1.235, p = 0.941) and ARB vs non-ARB (OR 0.946, CI 0.735 to 1.218, p = 0.668). This is the largest meta-analysis including critical events and mortality data on patients prescribed ACEi/ARB and found evidence of beneficial effects of chronic ACEi/ARB use especially in hypertensive cohort with COVID-19. As such, we would strongly encourage patients to continue with RAAS inhibitor pharmacotherapy during the COVID-19 pandemic.
Keyphrases
- end stage renal disease
- systematic review
- chronic kidney disease
- newly diagnosed
- blood pressure
- prognostic factors
- sars cov
- randomized controlled trial
- coronavirus disease
- type diabetes
- cardiovascular disease
- angiotensin ii
- machine learning
- metabolic syndrome
- deep learning
- angiotensin converting enzyme
- respiratory syndrome coronavirus