Key result
ACEI use is linked to ~28% lower in-hospital mortality vs other antihypertensives in hypertensive Covid-19 patients.
Why the study?
The relationship between ACEI or ARB use and acute hypoxemic respiratory failure and in-hospital mortality in hypertensive Covid-19 patients required investigation.
Does ACEI or ARB use reduce acute hypoxemic respiratory failure and in-hospital mortality in hypertensive Covid-19 patients compared to other antihypertensive drugs?
Observational (n=1,345)
Does ACEI or ARB use reduce acute hypoxemic respiratory failure and in-hospital mortality in hypertensive Covid-19 patients compared to other antihypertensive drugs?
Odds Ratio: 0.718 (95% CI 0.521–0.988)
p-value: p=0.042
The use of ACEI or ARB drugs in hypertensive COVID-19 patients did not show a clinically significant difference in in-hospital mortality compared to other antihypertensives.
Introduction We have aimed to investigate the relationship between use of angiotensin-converting-enzyme inhibitor (ACEI) or angiotensin-receptor-blocker (ARB) drugs and acute hypoxemic respiratory failure (AHRF) and in-hospital mortality in hypertensive Covid-19 patients.Material and method Consecutive 1345 patients diagnosed with Covid-19 between April and October 2020 who met inclusion criteria were divided into two groups based on presence and absence of AHRF and mortality. The groups were compared regarding epidemiological, clinical, radiological, laboratory findings and treatments methods. The patient groups ACEI, ARB and other antihypertensive drugs (non-ACEI/ARB) were compared regarding same parameters.Results Median age was 68 (60–76) years in the patient group including 805 (59.9.1%) females. Of the patients, 475 (35.3%), 644 (47.9%) and 226 (16.8%) were using ACEIs, ARBs and non-ACEI/ARB, respectively. AHRF and in-hospital mortality developed in 1053 (78.3%) and 290 (21.6%) patients, respectively. Age, gender, coronary artery disease, diabetes mellitus (DM), neutrophil, lymphocyte, creatinine, D-dimer, C-reactive protein (CRP), ACEI, beta blocker and aspartate transaminase (AST) found statistically significant in the univariable logistic regression performed to identify independent predictors of mortality were included multivariable logistic regression model. Age (OR: 1.066, 95%CI: 1.049–1.083; p < .001), DM (OR: 1.682, 95%CI: 1.238–2.286; p = .001), neutrophil (OR: 1.041, 95%CI: 1.007–1.077; p = .019), creatinine (OR: 1.178, 95%CI: 1.048–1.325; p = .006), CRP (OR: 1.008, 95%CI: 1.006–1.010; p < .001), ACEI (OR: 0.718, 95%CI: 0.521–0.988; p = .042), AST (OR: 1.005, 95%CI: 1.001–1.010; p = .010) were found associated with in-hospital mortality.Conclusion In our study, it was not detected clinically significant difference between three groups with regard to their relation with in-hospital mortality.
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Akyüz et al. (2021) conducted an observational in Hypertensive Covid-19 (n=1,345). ACEI or ARB drugs vs. Other antihypertensive drugs (non-ACEI/ARB) was evaluated on In-hospital mortality (OR 0.718, 95% CI 0.521-0.988, p=0.042). Among hypertensive Covid-19 patients, ACEI use was associated with lower in-hospital mortality (OR 0.718; 95% CI 0.521-0.988; p=0.042) compared to other antihypertensives.
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