- In patients with COVID-19, angiotensin-converting enzyme (ACE) inhibitors (ACEIs)/angiotensin II receptor blockers (ARBs) are linked to reduced mortality risk.
- Results are from a retrospective study of in-hospital use of the drugs in China.
Why this matters
- Because of the involvement of ACE receptors in SARS-CoV-2 infection, questions had arisen about whether patients with COVID-19 should continue these therapies.
- Most cardiac societies have recommended continuation, but concerns have persisted.
- 28-day all-cause mortality (unadjusted) was lower among patients taking ACEIs/ARBs:
- 3.7% vs 9.8% among those not on these therapies (P=.01).
- With adjustment, mortality risk was significantly lower in the ACEI/ARB group:
- adjusted HR (aHR), 0.42 (95% CI, 0.19-0.92).
- Among patients taking any antihypertensives, those taking ACEIs/ARBs still had decreased mortality vs those taking other antihypertensives:
- aHR, 0.30 (95% CI, 0.13-0.71).
- The pattern held in propensity score-matched analyses with several adjustments.
- Patients taking ACEIs/ARBs also had reduced risk for septic shock vs those not taking them:
- aHR, 0.36 (95% CI, 0.16-0.84).
- Hypertension itself was, as expected, a risk factor for mortality:
- aHR, 1.41 (95% CI, 1.03-1.94).
- Retrospective study, 3430 patients (53.2% men; median age, 64 years) with COVID-19 at 9 hospitals in Hubei Province, China, December 31, 2019 to February 20, 2020.
- 1128 had hypertension, of whom 188 were taking ACEIs/ARBs.
- Funding: National Key R&D Program of China; others.
- Not all other medications before or during hospitalization fully captured.