Comparative Impacts of ACE (Angiotensin-Converting Enzyme) Inhibitors Versus Angiotensin II Receptor Blockers on the Risk of COVID-19 Mortality
2020; Lippincott Williams & Wilkins; Volume: 76; Issue: 2 Linguagem: Inglês
10.1161/hypertensionaha.120.15622
ISSN1524-4563
AutoresFeng Zhou, Ye-Mao Liu, Jing Xie, Haomiao Li, Fang Lei, Huilin Yang, Juan‐Juan Qin, Jingjing Cai, Xiao-Jing Zhang, Bin Wu, Xia Meng, Xiang Da, Chengzhang Yang, Xinliang Ma, Qingbo Xu, Zhigang Lu, Haofeng Lu, Xigang Xia, Daihong Wang, Xiaofeng Liao, Gang Peng, Jun Yang, Xiaodong Huang, Bing-Hong Zhang, Yufeng Yuan, Wei Xiang, Peter P. Liu, Yibin Wang, Peng Zhang, Zhi‐Gang She, Jiahong Xia, Hongliang Li,
Tópico(s)COVID-19 and Mental Health
ResumoHomeHypertensionVol. 76, No. 2Comparative Impacts of ACE (Angiotensin-Converting Enzyme) Inhibitors Versus Angiotensin II Receptor Blockers on the Risk of COVID-19 Mortality Free AccessLetterPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessLetterPDF/EPUBComparative Impacts of ACE (Angiotensin-Converting Enzyme) Inhibitors Versus Angiotensin II Receptor Blockers on the Risk of COVID-19 Mortality Feng Zhou, Ye-Mao Liu, Jing Xie, Haomiao Li, Fang Lei, Huilin Yang, Juan-Juan Qin, Jingjing Cai, Xiao-Jing Zhang, Bin Wu, Meng Xia, Da Xiang, Chengzhang Yang, Xinliang Ma, Qingbo Xu, Zhigang Lu, Haofeng Lu, Xigang Xia, Daihong Wang, Xiaofeng Liao, Gang Peng, Jun Yang, Xiaodong Huang, Bing-Hong Zhang, Yufeng Yuan, Xiang Wei, Peter P. Liu, Yibin Wang, Peng Zhang, Zhi-Gang She, Jiahong Xia and Hongliang Li Feng ZhouFeng Zhou From the Medical Science Research Center, Zhongnan Hospital of Wuhan University, China (F.Z., P.Z., Hongliang Li) Institute of Model Animal (F.Z., Y.-M.L., Haomiao Li, F.L., H.Y., J.-J.Q., X.-J.Z., B.W., M.X., D.X., C.Y., P.Z., Z.-G.S., Hongliang Li), Wuhan University, China Basic Medical School (F.Z., Hongliang Li), Wuhan University, China Department of Cardiology (F.Z., Y.-M.L., J.X., Haomiao Li, J.-J.Q., X.-J.Z., B.W., Z.-G.S., Hongliang Li), Renmin Hospital of Wuhan University, China , Ye-Mao LiuYe-Mao Liu Institute of Model Animal (F.Z., Y.-M.L., Haomiao Li, F.L., H.Y., J.-J.Q., X.-J.Z., B.W., M.X., D.X., C.Y., P.Z., Z.-G.S., Hongliang Li), Wuhan University, China Department of Cardiology (F.Z., Y.-M.L., J.X., Haomiao Li, J.-J.Q., X.-J.Z., B.W., Z.-G.S., Hongliang Li), Renmin Hospital of Wuhan University, China , Jing XieJing Xie Institute of Model Animal (F.Z., Y.-M.L., Haomiao Li, F.L., H.Y., J.-J.Q., X.-J.Z., B.W., M.X., D.X., C.Y., P.Z., Z.-G.S., Hongliang Li), Wuhan University, China Department of Cardiology (F.Z., Y.-M.L., J.X., Haomiao Li, J.-J.Q., X.-J.Z., B.W., Z.-G.S., Hongliang Li), Renmin Hospital of Wuhan University, China , Haomiao LiHaomiao Li Institute of Model Animal (F.Z., Y.-M.L., Haomiao Li, F.L., H.Y., J.-J.Q., X.-J.Z., B.W., M.X., D.X., C.Y., P.Z., Z.-G.S., Hongliang Li), Wuhan University, China Department of Cardiology (F.Z., Y.-M.L., J.X., Haomiao Li, J.-J.Q., X.-J.Z., B.W., Z.-G.S., Hongliang Li), Renmin Hospital of Wuhan University, China , Fang LeiFang Lei Institute of Model Animal (F.Z., Y.-M.L., Haomiao Li, F.L., H.Y., J.-J.Q., X.-J.Z., B.W., M.X., D.X., C.Y., P.Z., Z.-G.S., Hongliang Li), Wuhan University, China , Huilin YangHuilin Yang Institute of Model Animal (F.Z., Y.-M.L., Haomiao Li, F.L., H.Y., J.-J.Q., X.-J.Z., B.W., M.X., D.X., C.Y., P.Z., Z.-G.S., Hongliang Li), Wuhan University, China , Juan-Juan QinJuan-Juan Qin Institute of Model Animal (F.Z., Y.-M.L., Haomiao Li, F.L., H.Y., J.-J.Q., X.-J.Z., B.W., M.X., D.X., C.Y., P.Z., Z.-G.S., Hongliang Li), Wuhan University, China Department of Cardiology (F.Z., Y.-M.L., J.X., Haomiao Li, J.-J.Q., X.-J.Z., B.W., Z.-G.S., Hongliang Li), Renmin Hospital of Wuhan University, China , Jingjing CaiJingjing Cai Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, China (J.C.) , Xiao-Jing ZhangXiao-Jing Zhang Institute of Model Animal (F.Z., Y.-M.L., Haomiao Li, F.L., H.Y., J.-J.Q., X.-J.Z., B.W., M.X., D.X., C.Y., P.Z., Z.-G.S., Hongliang Li), Wuhan University, China Department of Cardiology (F.Z., Y.-M.L., J.X., Haomiao Li, J.-J.Q., X.-J.Z., B.W., Z.-G.S., Hongliang Li), Renmin Hospital of Wuhan University, China , Bin WuBin Wu Institute of Model Animal (F.Z., Y.-M.L., Haomiao Li, F.L., H.Y., J.-J.Q., X.-J.Z., B.W., M.X., D.X., C.Y., P.Z., Z.-G.S., Hongliang Li), Wuhan University, China Department of Cardiology (F.Z., Y.-M.L., J.X., Haomiao Li, J.-J.Q., X.-J.Z., B.W., Z.-G.S., Hongliang Li), Renmin Hospital of Wuhan University, China , Meng XiaMeng Xia Institute of Model Animal (F.Z., Y.-M.L., Haomiao Li, F.L., H.Y., J.-J.Q., X.-J.Z., B.W., M.X., D.X., C.Y., P.Z., Z.-G.S., Hongliang Li), Wuhan University, China , Da XiangDa Xiang Institute of Model Animal (F.Z., Y.-M.L., Haomiao Li, F.L., H.Y., J.-J.Q., X.-J.Z., B.W., M.X., D.X., C.Y., P.Z., Z.-G.S., Hongliang Li), Wuhan University, China , Chengzhang YangChengzhang Yang Institute of Model Animal (F.Z., Y.-M.L., Haomiao Li, F.L., H.Y., J.-J.Q., X.-J.Z., B.W., M.X., D.X., C.Y., P.Z., Z.-G.S., Hongliang Li), Wuhan University, China , Xinliang MaXinliang Ma Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania (X.M.) , Qingbo XuQingbo Xu Centre for Clinic Pharmacology, The William Harvey Research Institute, Queen Mary University of London, United Kingdom (Q.X.) , Zhigang LuZhigang Lu Department of Neurology, The First People's Hospital of Jingmen affiliated to Hubei Minzu University, Jingmen, China (Z.L.) , Haofeng LuHaofeng Lu Department of Hepatobiliary Surgery, The First Affiliated Hospital of Changjiang University, Jingzhou, China (Haofeng Lu) , Xigang XiaXigang Xia Department of Hepatobiliary Surgery, Jingzhou Central Hospital, China (X.X.) , Daihong WangDaihong Wang Department of Hepatobiliary and Pancreatic Surgery, Xianning Central Hospital, Hubei Province, China (D.W.) , Xiaofeng LiaoXiaofeng Liao Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, China (X.L.) , Gang PengGang Peng Department of Hepatobiliary and Pancreatic Surgery, Suizhou central Hospital Affiliated to Hubei Medical College, China (G.P.) , Jun YangJun Yang Department of Cardiology, The First College of Clinical Medical Science, China Three Gorges University & Yichang Central People's Hospital and Institute of Cardiovascular Diseases, China Three Gorges University (J.Y.) , Xiaodong HuangXiaodong Huang Department of Gastroenterology, Wuhan Third Hospital & Tongren Hospital of Wuhan University, China (X.H.) , Bing-Hong ZhangBing-Hong Zhang Departments of Neonatology (B.-H.Z.), Renmin Hospital of Wuhan University, China , Yufeng YuanYufeng Yuan Department of Hepatobiliary and Pancreatic Surgery, Zhongnan Hospital of Wuhan University, China (Y.Y) , Xiang WeiXiang Wei Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (X.W.) , Peter P. LiuPeter P. Liu Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, ON, Canada (P.P.L.) , Yibin WangYibin Wang Departments of Anesthesiology, Physiology and Medicine, Cardiovascular Research Laboratories, David Geffen School of Medicine, University of California, Los Angeles (Y.W.) , Peng ZhangPeng Zhang From the Medical Science Research Center, Zhongnan Hospital of Wuhan University, China (F.Z., P.Z., Hongliang Li) Institute of Model Animal (F.Z., Y.-M.L., Haomiao Li, F.L., H.Y., J.-J.Q., X.-J.Z., B.W., M.X., D.X., C.Y., P.Z., Z.-G.S., Hongliang Li), Wuhan University, China , Zhi-Gang SheZhi-Gang She Institute of Model Animal (F.Z., Y.-M.L., Haomiao Li, F.L., H.Y., J.-J.Q., X.-J.Z., B.W., M.X., D.X., C.Y., P.Z., Z.-G.S., Hongliang Li), Wuhan University, China Department of Cardiology (F.Z., Y.-M.L., J.X., Haomiao Li, J.-J.Q., X.-J.Z., B.W., Z.-G.S., Hongliang Li), Renmin Hospital of Wuhan University, China , Jiahong XiaJiahong Xia Department of Cardiovascular Surgery, Union Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, China (J.X.). and Hongliang LiHongliang Li Correspondence to Hongliang Li, Medical Science Research Center, Zhongnan Hospital of Wuhan University, 169 Donghu Rd, Wuhan, 430072, China. Email E-mail Address: [email protected] https://orcid.org/0000-0002-9821-0297 From the Medical Science Research Center, Zhongnan Hospital of Wuhan University, China (F.Z., P.Z., Hongliang Li) Institute of Model Animal (F.Z., Y.-M.L., Haomiao Li, F.L., H.Y., J.-J.Q., X.-J.Z., B.W., M.X., D.X., C.Y., P.Z., Z.-G.S., Hongliang Li), Wuhan University, China Basic Medical School (F.Z., Hongliang Li), Wuhan University, China Department of Cardiology (F.Z., Y.-M.L., J.X., Haomiao Li, J.-J.Q., X.-J.Z., B.W., Z.-G.S., Hongliang Li), Renmin Hospital of Wuhan University, China Originally published3 Jun 2020https://doi.org/10.1161/HYPERTENSIONAHA.120.15622Hypertension. 2020;76:e15–e17Other version(s) of this articleYou are viewing the most recent version of this article. Previous versions: June 4, 2020: Ahead of Print Treating coronavirus disease 2019 (COVID-19) using ACE (angiotensin-converting enzyme) inhibitors and angiotensin II receptor blockers (ARBs) is a clinical dilemma due to the perceived risk of exacerbating COVID-19 by elevating ACE2 expression.1 Despite recent studies showing no harm to continue ACE inhibitors/ARBs in the setting of COVID-19,2,3 it is still unknown whether ACE inhibitors and ARBs have equivalent impacts on COVID-19 mortality among patients preexisting different indications.To address this critical question, in this multi-centered retrospective study, we enrolled 15 504 participants diagnosed as COVID-19 and admitted to 17 hospitals located at Hubei Province, China, from December 31, 2019 to April 21, 2020. A total of 3572 eligible participants (aged 66 [interquartile range, 58–72] years, 51.1% male sex) with ACE inhibitors/ARBs indications and hospitalized due to COVID-19 were included in our analysis, whereas patients without taking any drugs for treating ACE inhibitors/ARBs indications or recorded hypotension shock within 24 hours after admission were excluded (Figure [A]). Data collection, extraction, and analysis were conducted in a standard procedure by a team of physicians, analysts, and statisticians. The study design and procedures were approved by the central ethics committee and were accepted or approved by the local ethics committees of all participating hospitals. Informed consent forms were waived by each ethics committee. The data that support the findings of this study are available from the corresponding author upon reasonable request.Download figureDownload PowerPointFigure. The flowchart of patient enrollment and the associations of ACE (angiotensin-converting enzyme) inhibitors and angiotensin II receptor blockers (ARBs) with 28-d all-cause death of coronavirus disease 2019 (COVID-19). A, Flow chart of enrolling patients in this study. B, Forest plots showing the associations of in-hospital use of ACE inhibitors/ARBs vs non-ACE inhibitors/ARBs with 28-d all-cause death of COVID-19 among patients with different indications. C, Kaplan-Meier curves showing percent survivals in ACE inhibitors/ARBs and non-ACE inhibitors/ARBs groups among patients with all ACE inhibitors/ARBs indications. The blips indicate censoring. D, Forest plots showing the comparative associations of inpatients receiving ACE inhibitors or ARBs or other therapeutic agents with 28-d death of COVID-19 among patients having indications for taking ACE inhibitors/ARBs. E, Kaplan-Meier curves showing percent survival among patients in ARBs/ARBs groups during 28 d after admission. The blips indicate censoring. ACEI indicates ACE inhibitors; CAD, coronary artery disease; EMR, electronic medical records; HYP, hypertension; and PSM, propensity score–matched.We analyzed the associations between in-hospital use of ACE inhibitors/ARBs and 28-day all-cause death of COVID-19 compared to the use of non-ACE inhibitors/ARBs agents using propensity score–matched analysis where age, sex, disease severity, comorbidities, and calcium channel blockers medication usage were matched. And 906 ACE inhibitors/ARBs treated subjects were successfully matched with 1812 subjects treated with non-ACE inhibitors/ARBs agents during hospitalization at a ratio of 1:2. After further adjusting for imbalanced variables and in-hospital medications, the in-hospital use of ACE inhibitors/ARBs was significantly associated with lower risk of 28-day all-cause mortality of COVID-19 (adjusted hazard ratio [HR], 0.39 [95% CI, 0.26–0.58]; P<0.001) compared with the non-ACE inhibitors/ARBs group. Notably, patients in the ACE inhibitors/ARBs groups had significantly lower risk of 28-day all-cause mortality of COVID-19 among patients with hypertension (adjusted HR, 0.32 [95% CI, 0.15–0.66]; P=0.002), hypertension combined with coronary artery disease (adjusted HR, 0.11 [95% CI, 0.04–0.31]; P<0.001), and coronary artery disease (adjusted HR, 0.38 [95% CI, 0.16–0.89]; P=0.03; Figure [B] and [C]). Thus, patients with hypertension and coronary artery disease might obtain benefits from taking ACE inhibitors/ARBs compared with the non-ACE inhibitors/ARBs in the setting of COVID-19.Although ACE inhibitors and ARBs are commonly considered interchangeable in treating hypertension, cardiac diseases, and chronic kidney diseases in clinic application,4 their risks and benefits must be reconsidered when facing COVID-19 in light of the involvement of pulmonary and multiorgan symptoms.5 We thus further evaluated ACE inhibitors and ARBs specific associations with the risk of 28-day mortality for COVID-19. A total of 124 participants taking ACE inhibitors (aged 65 [interquartile range, 59–71] years, 62.9% male) were matched with 248 subjects taking ARBs (aged 64 [interquartile range, 56–72] years, 59.7% male) by propensity score matching. Importantly, the risk of 28-day all-cause mortality of COVID-19 was not significantly different between the patients taking ACE inhibitors versus the ones taking ARBs during hospitalization, despite the fact that the risk of death trended higher in the ACE inhibitors group (adjusted HR, 2.02 [95% CI, 0.56–7.27]; P=0.28; Figure [D]).Notably, in-hospital use of ARBs was associated with a significantly reduced mortality (adjusted HR, 0.31 [95% CI, 0.18–0.53]; P<0.001) compared with non-ARB agents during 28-day follow-up, whereas ACE inhibitors showed no significant association with the 28-day mortality compared to non-ACE inhibitors drugs (adjusted HR, 0.49 [95% CI, 0.20–1.20]; P=0.12; Figure [D] and [E]) among patients with indications for ACE inhibitor/ARBs and infected by severe acute respiratory syndrome coronavirus 2. These data suggested that ARBs medication consistently showed beneficial effects in reducing mortality in COVID-19, but ACE inhibitor specific effects appeared to be less homogenous.In conclusion, based on the large-scale retrospective study, we demonstrated that in-hospital use of ACE inhibitors/ARBs was associated with a lower risk of 28-day death among hospitalized patients with COVID-19 and coexisting hypertension, coronary artery disease and hypertension combined with coronary artery disease. These data suggested that patients with hypertension and coronary artery disease might obtain benefits from taking ACE inhibitors/ARBs compared to the non-ACE inhibitors/ARBs in the setting of COVID-19. Notably, in-hospital usage of ACE inhibitors tended to have a higher incidence and risk of 28-day COVID-19 mortality than those taking ARBs, but the difference was not statistically significant. Nevertheless, this should be interpreted with caution since the observations were obtained from a retrospective study and might be possibly overcome to null by unmeasured confounders. Despite large-scale and geographically diverse prospective studies and randomized controlled trials are still required, this retrospective study based on a large cohort provides actionable information to clinical physicians for treating patients with ACE inhibitors/ARBs indications and infected with severe acute respiratory syndrome coronavirus 2.Sources of FundingNone.DisclosuresNone.Footnotes*These authors contributed equally.Correspondence to Hongliang Li, Medical Science Research Center, Zhongnan Hospital of Wuhan University, 169 Donghu Rd, Wuhan, 430072, China. Email lihl@whu.edu.cnReferences1. Danser AHJ, Epstein M, Batlle D. Renin-angiotensin system blockers and the COVID-19 pandemic: at the present there is no evidence to abandon renin angiotensin system blockers.Hypertension. 2020; 75:1382–1385. doi: 10.1161/HYPERTENSIONAHA.120.15082LinkGoogle Scholar2. Vaduganathan M, Vardeny O, Michel T, McMurray JJV, Pfeffer MA, and Solomon SD. Renin-angiotensin aldosterone system inhibitors in patients with Covid-19.N Engl J Med. 2020; 382:1653–1659. doi: 10.1056/NEJMsr2005760CrossrefMedlineGoogle Scholar3. Zhang P, Zhu L, Cai J, Lei F, Qin JJ, Xie J, Liu YM, Zhao YC, Huang X, Lin L, et al. Association of inpatient use of angiotensin converting enzyme inhibitors and angtiotensin II receptor blockers with mortality among patients with hypertension hospitalized with COVID-19.Circ Res. 2020; 126:1671–1681. doi: 10.1161/CIRCRESAHA.120.317134LinkGoogle Scholar4. Hsu TW, Liu JS, Hung SC, Kuo KL, Chang YK, Chen YC, Hsu CC, Tarng DC. Renoprotective effect of renin-angiotensin-aldosterone system blockade in patients with predialysis advanced chronic kidney disease, hypertension, and anemia.JAMA Intern Med. 2014; 174:347–354. doi: 10.1001/jamainternmed.2013.12700CrossrefMedlineGoogle Scholar5. Mancini GB, Etminan M, Zhang B, Levesque LE, FitzGerald JM, Brophy JM. Reduction of morbidity and mortality by statins, angiotensin-converting enzyme inhibitors, and angiotensin receptor blockers in patients with chronic obstructive pulmonary disease.J Am Coll Cardiol. 2006; 47:2554–2560. doi: 10.1016/j.jacc.2006.04.039CrossrefMedlineGoogle Scholar eLetters(0)eLetters should relate to an article recently published in the journal and are not a forum for providing unpublished data. Comments are reviewed for appropriate use of tone and language. Comments are not peer-reviewed. Acceptable comments are posted to the journal website only. Comments are not published in an issue and are not indexed in PubMed. Comments should be no longer than 500 words and will only be posted online. References are limited to 10. Authors of the article cited in the comment will be invited to reply, as appropriate.Comments and feedback on AHA/ASA Scientific Statements and Guidelines should be directed to the AHA/ASA Manuscript Oversight Committee via its Correspondence page.Sign In to Submit a Response to This Article Previous Back to top Next FiguresReferencesRelatedDetailsCited By Kashour T, Bin Abdulhak A, Tlayjeh H, Hassett L, Noman A, Mohsen A, Al-Mallah M and Tleyjeh I (2023)(2020) Angiotensin Converting Enzyme Inhibitors and Angiotensin Receptor Blockers and Mortality Among COVID-19 Patients: A Systematic Review and Meta-Analysis, American Journal of Therapeutics, 10.1097/MJT.0000000000001281, 30:4, (e336-e346) Chen H, Peng J, Wang T, Wen J, Chen S, Huang Y and Zhang Y (2023) Counter-regulatory renin-angiotensin system in hypertension: Review and update in the era of COVID-19 pandemic, Biochemical Pharmacology, 10.1016/j.bcp.2022.115370, 208, (115370), Online publication date: 1-Feb-2023. Kebria M, Milan P, Peyravian N, Kiani J, Khatibi S and Mozafari M (2022) Stem cell therapy for COVID-19 pneumonia, Molecular Biomedicine, 10.1186/s43556-021-00067-8, 3:1, Online publication date: 1-Dec-2022. Tsampasian V, Corballis N and Vassiliou V (2022) Renin–Angiotensin–Aldosterone Inhibitors and COVID-19 Infection, Current Hypertension Reports, 10.1007/s11906-022-01207-3, 24:10, (425-433), Online publication date: 1-Oct-2022. Sharma R, Kumar A, Majeed J, Thakur A and Aggarwal G (2022) Drugs acting on the renin–angiotensin–aldosterone system (RAAS) and deaths of COVID-19 patients: a systematic review and meta-analysis of observational studies, The Egyptian Heart Journal, 10.1186/s43044-022-00303-8, 74:1 Landolfo M, Maino A, Di Salvo E, Fiorini G, Peterlana D and Borghi C (2022) Renin–angiotensin system modulation and outcomes in patients hospitalized for interstitial SARS-CoV2 pneumonia: a cohort study, Internal and Emergency Medicine, 10.1007/s11739-022-02929-7, 17:5, (1335-1341), Online publication date: 1-Aug-2022. Loader J, Taylor F, Lampa E and Sundström J (2022) Renin‐Angiotensin Aldosterone System Inhibitors and COVID‐19: A Systematic Review and Meta‐Analysis Revealing Critical Bias Across a Body of Observational Research, Journal of the American Heart Association, 11:11, Online publication date: 7-Jun-2022. Jiang X, Li H, Liu Y, Bao L, Zhan L, Gao H, Deng W, Xue J, Liu J, Liu X, Li J, Wang J, Wu S, Yan M, Luo W, Jose P, Qin C, Yang X, Zhang D and Yang Z (2022) The Effects of ATIR Blocker on the Severity of COVID-19 in Hypertensive Inpatients and Virulence of SARS-CoV-2 in Hypertensive hACE2 Transgenic Mice, Journal of Cardiovascular Translational Research, 10.1007/s12265-021-10147-3, 15:1, (38-48), Online publication date: 1-Feb-2022. Singh R, Rathore S, Khan H, Bhurwal A, Sheraton M, Ghosh P, Anand S, Makadia J, Ayesha F, Mahapure K, Mehra I, Tekin A, Kashyap R and Bansal V (2022) Mortality and Severity in COVID-19 Patients on ACEIs and ARBs—A Systematic Review, Meta-Analysis, and Meta-Regression Analysis, Frontiers in Medicine, 10.3389/fmed.2021.703661, 8 de Abajo F, Rodríguez-Miguel A, Rodríguez-Martín S, Lerma V, García-Lledó A, de Abajo F, Rodríguez-Miguel A, Rodríguez-Martín S, Lerma V, García-Lledó A, Barreira-Hernández D, Rodríguez-Puyol D, Laosa O, Pedraza L, Rodríguez-Mañas L, Aguilar M, de Pablo I, Gálvez M, García-Luque A, Puerro M, Aparicio R, García-Rosado V, Gutiérrez-Ortega C, Laredo L, González-Rojano E, Pérez C, Ascaso A, Elvira C, Mejía-Abril G, Zubiaur P, Santos-Molina E, Pintos-Sánchez E, Navares-Gómez M, Abad-Santos F, Centeno G, Sancho-Lopez A, Payares-Herrera C and Diago-Sempere E (2021) Impact of in-hospital discontinuation with angiotensin receptor blockers or converting enzyme inhibitors on mortality of COVID-19 patients: a retrospective cohort study, BMC Medicine, 10.1186/s12916-021-01992-9, 19:1, Online publication date: 1-Dec-2021. Dominiczak A and Meyer T (2021) Hypertension Update: A Reflection of the Past Decade, Hypertension, 78:6, (1670-1673), Online publication date: 1-Dec-2021. Gault N, Esposito‐Farèse M, Revest M, Inamo J, Cabié A, Polard É, Hulot J, Ghosn J, Chirouze C, Deconinck L, Diehl J, Poissy J, Epaulard O, Lefèvre B, Piroth L, De Montmollin E, Oziol E, Etienne M, Laouénan C, Rossignol P, Costagliola D and Vidal‐Petiot E (2021) Chronic use of renin‐angiotensin‐aldosterone system blockers and mortality in COVID‐19: A multicenter prospective cohort and literature review, Fundamental & Clinical Pharmacology, 10.1111/fcp.12683, 35:6, (1141-1158), Online publication date: 1-Dec-2021. Jia N, Zhang G, Sun X, Wang Y, Zhao S, Chi W, Dong S, Xia J, Zeng P and Liu D (2021) Influence of angiotensin converting enzyme inhibitors/angiotensin receptor blockers on the risk of all‐cause mortality and other clinical outcomes in patients with confirmed COVID‐19: A systemic review and meta‐analysis, The Journal of Clinical Hypertension, 10.1111/jch.14329, 23:9, (1651-1663), Online publication date: 1-Sep-2021. Loader J, Lampa E, Gustafsson S, Cars T and Sundström J (2021) Renin‐Angiotensin Aldosterone System Inhibitors in Primary Prevention and COVID‐19, Journal of the American Heart Association, 10:15, Online publication date: 3-Aug-2021. Tse G, Zhou J, Lee S, Wong W, Li X, Liu T, Cao Z, Zeng D, Wai A, Wong I, Cheung B and Zhang Q (2021) Relationship between angiotensin-converting enzyme inhibitors or angiotensin receptor blockers and COVID-19 incidence or severe disease, Journal of Hypertension, 10.1097/HJH.0000000000002866, 39:8, (1717-1724), Online publication date: 1-Aug-2021. Roy-Vallejo E, Sánchez Purificación A, Torres Peña J, Sánchez Moreno B, Arnalich F, García Blanco M, López Miranda J, Romero-Cabrera J, Herrero Gil C, Bascunana J, Rubio-Rivas M, Pintos Otero S, Martínez Sempere V, Ballano Rodríguez-Solís J, Gil Sánchez R, Luque del Pino J, González Noya A, Navas-Alcántara M, Cortés Rodríguez B, Alcalá J, Suárez-Lombraña A, Andrés Soler J, Gómez-Huelgas R, Casas-Rojo J and Millán Núñez-Cortés J (2021) Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers Withdrawal Is Associated with Higher Mortality in Hospitalized Patients with COVID-19, Journal of Clinical Medicine, 10.3390/jcm10122642, 10:12, (2642) Chen Z, Chen J, Zhou J, Lei F, Zhou F, Qin J, Zhang X, Zhu L, Liu Y, Wang H, Chen M, Zhao Y, Xie J, Shen L, Song X, Zhang X, Yang C, Liu W, Zhang X, Guo D, Yan Y, Liu M, Mao W, Liu L, Ye P, Xiao B, Luo P, Zhang Z, Lu Z, Wang J, Lu H, Xia X, Wang D, Liao X, Peng G, Liang L, Yang J, Chen G, Azzolini E, Aghemo A, Ciccarelli M, Condorelli G, Stefanini G, Wei X, Zhang B, Huang X, Xia J, Yuan Y, She Z, Guo J, Wang Y, Zhang P and Li H (2021) A risk score based on baseline risk factors for predicting mortality in COVID-19 patients, Current Medical Research and Opinion, 10.1080/03007995.2021.1904862, 37:6, (917-927), Online publication date: 3-Jun-2021. Miličić Stanić B, Maddox S, de Souza A, Wu X, Mehranfard D, Ji H, Speth R and Sandberg K (2021) Male bias in ACE2 basic science research: missed opportunity for discovery in the time of COVID-19, American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 10.1152/ajpregu.00356.2020, 320:6, (R925-R937), Online publication date: 1-Jun-2021. Chu C, Zeng S, Hasan A, Hocher C, Krämer B and Hocher B (2020) Comparison of infection risks and clinical outcomes in patients with and without SARS‐CoV‐2 lung infection under renin–angiotensin–aldosterone system blockade: Systematic review and meta‐analysis, British Journal of Clinical Pharmacology, 10.1111/bcp.14660, 87:6, (2475-2492), Online publication date: 1-Jun-2021. Xu J, Teng Y, Shang L, Gu X, Fan G, Chen Y, Tian R, Zhang S and Cao B (2020) The Effect of Prior Angiotensin-Converting Enzyme Inhibitor and Angiotensin Receptor Blocker Treatment on Coronavirus Disease 2019 (COVID-19) Susceptibility and Outcome: A Systematic Review and Meta-analysis, Clinical Infectious Diseases, 10.1093/cid/ciaa1592, 72:11, (e901-e913), Online publication date: 1-Jun-2021. Ma J, Shi X, Yu J, Lv F, Wu J, Sheng X, Pan Q, Yang J, Cao H and Li L (2021) Association of ACEi/ARB Use and Clinical Outcomes of COVID-19 Patients With Hypertension, Frontiers in Cardiovascular Medicine, 10.3389/fcvm.2021.577398, 8 Ren L, Yu S, Xu W, Overton J, Chiamvimonvat N and Thai P (2021) Lack of association of antihypertensive drugs with the risk and severity of COVID-19: A meta-analysis, Journal of Cardiology, 10.1016/j.jjcc.2020.10.015, 77:5, (482-491), Online publication date: 1-May-2021. Dai X, An Z, Wang Z, Wang Z and Wang Y (2021) Associations Between the Use of Renin–Angiotensin System Inhibitors and the Risks of Severe COVID-19 and Mortality in COVID-19 Patients With Hypertension: A Meta-Analysis of Observational Studies, Frontiers in Cardiovascular Medicine, 10.3389/fcvm.2021.609857, 8 Bavishi C, Whelton P, Mancia G, Corrao G and Messerli F (2021) Renin–angiotensin-system inhibitors and all-cause mortality in patients with COVID-19: a systematic review and meta-analysis of observational studies, Journal of Hypertension, 10.1097/HJH.0000000000002784, 39:4, (784-794), Online publication date: 1-Apr-2021. Yokoyama Y, Aikawa T, Takagi H, Briasoulis A and Kuno T (2020) Association of renin‐angiotensin‐aldosterone system inhibitors with mortality and testing positive of COVID‐19: Meta‐analysis, Journal of Medical Virology, 10.1002/jmv.26588, 93:4, (2084-2089), Online publication date: 1-Apr-2021. ElAbd R, AlTarrah D, AlYouha S, Bastaki H, Almazeedi S, Al-Haddad M, Jamal M and AlSabah S (2021) Angiotensin-Converting Enzyme (ACE) Inhibitors and Angiotensin Receptor Blockers (ARB) Are Protective Against ICU Admission and Mortality for Patients With COVID-19 Disease, Frontiers in Medicine, 10.3389/fmed.2021.600385, 8 Gressens S, Leftheriotis G, Dussaule J, Flamant M, Levy B and Vidal-Petiot E (2021) Controversial Roles of the Renin Angiotensin System and Its Modulators During the COVID-19 Pandemic, Frontiers in Physiology, 10.3389/fphys.2021.624052, 12 Banwait R, Singh D, Blanco A, Rastogi V and Abusaada K Renin-Angiotensin-Aldosterone System Blockers Prior to Hospitalization and Their Association With Clinical Outcomes in Coronavirus Disease 2019 (COVID-19), Cureus, 10.7759/cureus.13429 Mackey K, Kansagara D and Vela K (2021) Update Alert 7: Risks and Impact of Angiotensin-Converting Enzyme Inhibitors or Angiotensin-Receptor Blockers on SARS-CoV-2 Infection in Adults, Annals of Internal Medicine, 10.7326/L20-1446, 174:2, (W25-W29), Online publication date: 1-Feb-2021. Yanes Cardozo L, Rezq S, Pruett J and Romero D (2021) Androgens, the kidney, and COVID-19: an opportunity for translational research, American Journal of Physiology-Renal Physiology, 10.1152/ajprenal.00601.2020, 320:2, (F243-F248), Online publication date: 1-Feb-2021. Morales D, Conover M, You S, Pratt N, Kostka K, Duarte-Salles T, Fernández-Bertolín S, Aragón M, DuVall S, Lynch K, Falconer T, van Bochove K, Sung C, Matheny M, Lambert C, Nyberg F, Alshammari T, Williams A, Park R, Weaver J, Sena A, Schuemie M, Rijnbeek P, Williams R, Lane J, Prats-Uribe A, Zhang L, Areia C, Krumholz H, Prieto-Alhambra D, Ryan P, Hripcsak G and Suchard M (2021) Renin–angiotensin system blockers and susceptibility to COVID-19: an international, open science, cohort analysis, The Lancet Digital Health, 10.1016/S2589-7500(20)30289-2, 3:2, (e98-e114), Online publication date: 1-Feb-2021. Trougakos I, Stamatelopoulos K, Terpos E, Tsitsilonis O, Aivalioti E, Paraskevis D, Kastritis E, Pavlakis G and Dimopoulos M (2021) Insights to SARS-CoV-2 life cycle, pathophysiology, and rationalized treatments that target COVID-19 clinical complications, Journal of Biomedical Science, 10.1186/s12929-020-00703-5, 28:1 Ferrari F, Martins V, Fuchs F and Stein R (2021) Renin-Angiotensin-Aldosterone System Inhibitors in COVID-19: A Review, Clinics, 10.6061/clinics/2021/e2342, 76, (e2342), . Bumiller-Bini V, de Freitas Oliveira-Toré C, Carvalho T, Kretzschmar G, Gonçalves L, Alencar N, Gasparetto Filho M, Beltrame M and Winter Boldt A (2021) MASPs at the crossroad between the complement and the coagulation cascades - the case for COVID-19, Genetics and Molecular Biology, 10.1590/1678-4685-gmb-2020-0199, 44:1 suppl 1 Daniels L, Sitapati A, Zhang J, Zou J, Bui Q, Ren J, Longhurst C, Criqui M and Messer K (2020) Relation of Statin Use Prior to Admission to Severity and Recovery Among COVID-19 Inpatients, The American Journal of Cardiology, 10.1016/j.amjcard.2020.09.012, 136, (149-155), Online publication date: 1-Dec-2020. Hasan S, Kow C, Hadi M, Zaidi S and Merchant H (2020) Mortality and Disease Severity Among COVID-19 Patients Receiving Renin-Angiotensin System Inhibitors: A Systematic Review and Meta-analysis, American Journal of Cardiovascular Drugs, 10.1007/s40256-020-00439-5, 20:6, (571-590), Online publication date: 1-Dec-2020. Bellis A, Mauro C, Barbato E, Trimarco B and Morisco C (2020) The Rationale for Angiotensin Receptor Neprilysin Inhibitors in a Multi-Targeted Therapeutic Approach to COVID-19, International Journal of Molecular Sciences, 10.3390/ijms21228612, 21:22, (8612) Ferrario C, Ahmad S and Groban L (2020) Twenty years of progress in angiotensin converting enzyme 2 and its link to SARS-CoV-2 disease, Clinical Science, 10.1042/CS20200901, 134:19, (2645-2664), Online publication date: 16-Oct-2020. Mackey K, Kansagara D and Vela K (2020) Update Alert 3: Risks and Impact of Angiotensin-Converting Enzyme Inhibitors or Angiotensin-Receptor Blockers on SARS-CoV-2 Infection in Adults, Annals of Internal Medicine, 10.7326/L20-1068, 173:7, (130-131), Online publication date: 6-Oct-2020. Wang Y, Tse G, Li G, Lip G and Liu T (2020) ACE Inhibitors and Angiotensin II Receptor Blockers May Have Different Impact on Prognosis of COVID-19, Journal of the American College of Cardiology, 10.1016/j.jacc.2020.07.068, 76:17, (2041), Online publication date: 1-Oct-2020. de Fréminville J and Azizi M (2020) Inhibiteurs du système rénine-angiotensine au cours de la COVID-19 : protecteurs ou dangereux ?, Archives des Maladies du Coeur et des Vaisseaux - Pratique, 10.1016/j.amcp.2020.07.004, 2020:291, (20-24), Online publication date: 1-Oct-2020. Elijovich F and Laffer C (2020) What Kind of Evidence Is Needed to Dictate Practice Regarding Inhibitors of the Renin-Angiotensin System in COVID-19?, Hypertension, 76:3, (665-669), Online publication date: 1-Sep-2020. Nunes J (2020)(2020) Mortality and use of angiotensin-converting enzyme inhibitors in COVID 19 disease: a systematic review, Porto Biomedical Journal, 10.1097/j.pbj.0000000000000085, 5:6, (e085) August 2020Vol 76, Issue 2 Advertisement Article InformationMetrics © 2020 American Heart Association, Inc.https://doi.org/10.1161/HYPERTENSIONAHA.120.15622PMID: 32493070 Originally publishedJune 3, 2020 PDF download Advertisement
Referência(s)