Journal article
Association between RAAS Antagonism and COVID-19-related Mortality in Patients with Overweight/Obesity-related Hypertension: A Retrospective Cohort Study
Arquivos brasileiros de cardiologia, Vol.120(4), e20220277
03/2023
DOI: 10.36660/abc.20220277
PMCID: PMC10263421
PMID: 37098985
Appears in Diamond Open Access
Abstract
Angiotensin receptor blockers (ARB) and angiotensin-converting enzyme inhibitors (ACEI) increase the expression of ACE2, which is a receptor for entry of SARS-CoV-2 into cells. Though evidence suggests that ARB/ACEI are safe among the general population with COVID-19, their safety in patients with overweight/obesity-related hypertension deserves further evaluation.
We assessed the association between ARB/ACEI use and COVID-19 severity in patients with overweight/obesity-related hypertension.
This study included 439 adult patients with overweight/obesity (body mass index ≥ 25 kg/m2) and hypertension, diagnosed with COVID-19 and admitted to University of Iowa Hospitals and Clinic from March 1 to December 7, 2020. Mortality and severity of COVID-19 were evaluated based on length of stay in hospital, intensive care unit admission, use of supplemental oxygen, mechanical ventilation, and vasopressors. Multivariable logistic regression was used to examine the associations of ARB/ACEI use with mortality and other markers of COVID-19 severity, with a two-sided alpha set at 0.05.
Exposure to ARB (n = 91) and ACEI (n = 149) before hospitalization was significantly associated with lower mortality (odds ratio [OR] = 0.362, 95% confidence interval [CI] 0.149 to 0.880, p = 0.025) and a shorter length of stay (95% CI -0.217 to -0.025, p = 0.015). Additionally, patients using ARB/ACEI showed a non-significant trend toward lower intensive care unit admission (OR = 0.727, 95% CI 0.485 to 1.090, p = 0.123), use of supplemental oxygen (OR = 0.929, 95% CI 0.608 to 1.421, p = 0.734), mechanical ventilation (OR = 0.728, 95% CI 0.457 to 1.161, p = 0.182), and vasopressors (OR = 0.677, 95% CI 0.430 to 1.067, p = 0.093).
Results suggest that hospitalized patients with COVID-19 and overweight/obesity-related hypertension who were prescribed ARB/ACEI before admission to the hospital exhibit lower mortality and less severe COVID-19 than those who were not taking ARB/ACEI. The results also suggest that exposure to ARB/ACEI may protect patients with overweight/obesity-related hypertension from severe COVID-19 and death.
Details
- Title: Subtitle
- Association between RAAS Antagonism and COVID-19-related Mortality in Patients with Overweight/Obesity-related Hypertension: A Retrospective Cohort Study
- Creators
- Elham Shams - Division of Endocrinology and Metabolism, Department of Internal Medicine, University of lowa - EUAVijayvardhan Kamalumpundi - Carver College of Medicine, University of Iowa - EUALinhai Cheng - Division of Endocrinology and Metabolism, Department of Internal Medicine, University of lowa - EUAAdeyinka Taiwo - University of IowaAmal Shibli-Rahhal - University of IowaAyotunde O Dokun - University of IowaMarcelo L G Correia - Carver College of Medicine, University of Iowa - EUA
- Resource Type
- Journal article
- Publication Details
- Arquivos brasileiros de cardiologia, Vol.120(4), e20220277
- DOI
- 10.36660/abc.20220277
- PMID
- 37098985
- PMCID
- PMC10263421
- NLM abbreviation
- Arq Bras Cardiol
- eISSN
- 1678-4170
- Alternative title
- Associação entre o Antagonismo do Sistema Renina-Angiotensina-Aldosterona e a Mortalidade Relacionada à COVID-19 em Pacientes com Hipertensão Relacionada ao Sobrepeso/Obesidade: um Estudo Retrospectivo de Coorte
- Language
- Portuguese
- Date published
- 03/2023
- Academic Unit
- Molecular Physiology and Biophysics; Fraternal Order of Eagles Diabetes Research Center; Medicine Administration; Endocrinology and Metabolism; Internal Medicine
- Record Identifier
- 9984399495502771
Metrics
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