Key result
RAS blocker continuation is safe in COVID-19, but initiation in severe cases increases mortality ~31%.
Why the study?
Randomized controlled trials have assessed the effects of renin-angiotensin system blockers in adults with COVID-19, but pooled estimates of safety and efficacy were needed.
Does ACE inhibitor or ARB treatment improve or worsen clinical outcomes in adults with COVID-19?
Meta-Analysis (n=3,492)
Does ACE inhibitor or ARB treatment improve or worsen clinical outcomes in adults with COVID-19?
Relative Risk: 0.96 (95% CI 0.66–1.41)
ACE inhibitors and ARBs can be safely continued in non-severe COVID-19, but their initiation in critically ill patients may increase mortality and should be avoided.
No takes yet. Share an insight, caveat, or question.
Continuation of indicated RAS blockers is safe in non-severe COVID-19; extends RCT evidence against routine initiation in critically ill patients.
Lee et al. (2023) conducted a meta-analysis in COVID-19 (n=3,492). Renin-angiotensin system (RAS) blockers vs. No treatment / Discontinuation was evaluated on intensive care unit (ICU) admission (continuation vs discontinuation) (RR 0.96, 95% CI 0.66-1.41). Continuation of RAS blockers in COVID-19 did not increase ICU admission (RR 0.96; 95% CI 0.66-1.41), whereas initiation in severe cases increased all-cause death (RR 1.31; 95% CI 1.01-1.72).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: