Key result
ACEi or ARB use linked to ~3-fold higher hospital discharge rates in hypertensive COVID-19 patients.
Why the study?
Hypertension was linked to worse prognosis in COVID-19, and early pandemic concerns suggested ACEi or ARB use might lead to unfavorable outcomes in these patients.
Does the use of ACEi or ARB medications reduce death, invasive ventilatory support, or renal replacement therapy in hypertensive patients hospitalized with COVID-19?
Observational (n=374)
No
Does the use of ACEi or ARB medications reduce death, invasive ventilatory support, or renal replacement therapy in hypertensive patients hospitalized with COVID-19?
The continued use of ACEi/ARB medications in hypertensive patients hospitalized with COVID-19 is associated with a higher rate of hospital discharge and does not worsen clinical outcomes.
Introduction: A greater association of systemic arterial hypertension with worse prognosis in patients hospitalized with COVID-19 was described. Early in the pandemic, concerns were raised that the use of angiotensin-converting enzyme inhibitors (ACEis) and angiotensin receptor blockers (ARBs) could lead to unfavorable outcomes. Objective: To evaluate whether there is an association between the use of the ACEi and ARB medications with unfavorable outcomes in hypertensive patients hospitalized with COVID-19. Methods: This is a descriptive and retrospective study, collecting data through electronic medical records of patients with COVID-19 admitted to a University Hospital in 2020. Demographic data, use of ACEi or ARB medications, comorbidities, and outcomes, defined by the use of invasive ventilatory support (IVS), renal failure with progression to renal replacement therapy, and death were evaluated. Results: 700 medical records were analyzed, 374 were of hypertensive individuals. The mean age of the patients was 66 ± 14 years, 51% were male, and 89% were white. There was a significantly higher prevalence of hospital discharge among patients who received ACEi/ARB compared to those who did not take these medications, (p-value = 0.027). There was no statistically significant difference in the use of ACEi/ARB for IVS (p-value = 0.062) and for renal replacement therapy (p-value = 0.587). Conclusion: The use of ACEi/ARB drugs is not associated with worse outcomes in individuals with COVID-19. The present study demonstrated lower mortality rate associated with the use of these classes of drugs, similar to recent studies.
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Oliveira et al. (2025) conducted an observational in Hypertension and COVID-19 (n=374). ACE inhibitors or ARBs vs. No ACEi/ARB use was evaluated on Hospital discharge (r = 0.10, p=0.027). The use of ACE inhibitors or ARBs in hypertensive patients hospitalized with COVID-19 was associated with a significantly higher prevalence of hospital discharge compared to non-use (p=0.027).
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