Effect of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers on Clinical Outcome in COVID-۱۹ Patients with Hypertension

Background: Hypertension is the main factor to predict the severity and mortality of COVID-۱۹. The use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) is challenging. This study aimed to investigate the effect of ACEIs and ARBs on clinical outcomes in COVID-۱۹ patients with hypertension. Materials and Methods: This cross-sectional study was carried out on ۴۹۸ patients who were referred to Razi hospital following COVID-۱۹ development and also had hypertension. Patients were divided into two groups receiving drugs in the ACEIs and ARB's groups and those not receiving these drugs. The primary outcome was death up to one month after the onset of symptoms. Results: Cardiovascular disease in patients taking ACEIs/ARBs was higher (p<۰.۰۰۱). One hundred eleven deaths (۲۲.۳%) were seen in the studied patients in whom ۶۶ deaths (۵۹.۵%) belonged to the group not taking ACEIs and ARBs (p>۰.۰۵). Seventy-nine patients (۱۵.۸۶%) were admitted to ICU in which ۶۲.۰۳% of these patients died while the non-ICU mortality rate was ۱۴.۸% (Odds Ratio = ۹.۴۰; ۹۵% CI: ۵.۵۴ to ۱۵.۹۵, p <۰.۰۰۱). A subgroup analysis found that among patients with diabetes who had hypertension, the incidence of death was ۴۳.۵۵% in the group taking ARBs/ACEi lower than in another group significant (p = ۰.۰۲۱). Conclusion: The mortality rate in the patients taking ACEIs/ARBs is not different from other groups. It was found that among COVID-۱۹ patients with diabetes who had hypertension, the incidence of death in the patients taking ARBs/ACEi was lower than in another group.

کلیدواژه ها:

COVID-۱۹ ، SARS-CoV۲ ، angiotensin-converting enzyme inhibitor ، angiotensin receptor blocker ، ARBs ، ACEi