The effect of ACE inhibitors and ARBs on outcomes in hospitalized patients with COVID-19.

Narges Najafi, Alireza Davoudi, Hamideh Izadyar, Abbas Alishahi, Armaghan Mokhtariani, Bahareh Soleimanpourian, Mina Tabarrayi, Mahmood Moosazadeh, Zahra Daftarian, Fatemeh Ahangarkani

Irish journal of medical science 2023 Jun

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Contradictory opinions exist regarding the use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) in patients with hypertension, which is the most common comorbidity associated with COVID-19. Herein, the effects of ACEIs and ARBs on outcomes of COVID-19 patients were evaluated. In this cross-sectional study, the outcomes of COVID-19 patients were compared between patients who received pretreatment ACEIs or ARBs and those who did not. The incidence of moderate and severe forms of COVID-19 was significantly higher in patients taking ACEI/ARB drugs (P-value = 0.012). Also, patients taking ACEI/ARB drugs (P-value = 0.034), patients with hypertension (P-value = 0.011), and patients with dyslipidemia (P-value = 0.011) experienced more severe forms of COVID-19. There was an association between increased length of hospital stay and dyslipidemia (P-value = 0.033) and the use of ACEI/ARB drugs (P-value = 0.041), while no correlation was found between other parameters in univariate linear regression analysis as well as multivariate linear regression. There was an association between increased mortality of patients with increasing age (P-value < 0.001), BMI greater than 30 kg/m2 (P-value = 0.02), asthma (P-value = 0.003), and dyslipidemia (P-value = 0.045). ACEI/ARB drugs put COVID-19 patients at high risk for moderate to severe forms of COVID-19 and higher length of hospital stay. Although, it is notable that these drugs did not significantly affect specific adverse outcomes of COVID-19, such as the need for admission to the intensive care unit (ICU), length of ICU stay, ventilation, and mortality. © 2022. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.

Citation

Narges Najafi, Alireza Davoudi, Hamideh Izadyar, Abbas Alishahi, Armaghan Mokhtariani, Bahareh Soleimanpourian, Mina Tabarrayi, Mahmood Moosazadeh, Zahra Daftarian, Fatemeh Ahangarkani. The effect of ACE inhibitors and ARBs on outcomes in hospitalized patients with COVID-19. Irish journal of medical science. 2023 Jun;192(3):1517-1523