Association between renin‐angiotensin antagonism and COVID‐19–related mortality in patients with essential hypertension: A single center, retrospective cohort study

Vijayvardhan Kamalumpundi; Shuntaro Kawasaki; Linhai Cheng; Erin E. Meyers; Elham Shams; Ologibe Ofori; Assim Eddin; Marcelo L. G. Correia

doi:10.1111/jch.14869

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Association between renin‐angiotensin antagonism and COVID‐19–related mortality in patients with essential hypertension: A single center, retrospective cohort study

Journal article

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Association between renin‐angiotensin antagonism and COVID‐19–related mortality in patients with essential hypertension: A single center, retrospective cohort study

Vijayvardhan Kamalumpundi, Shuntaro Kawasaki, Linhai Cheng, Erin E. Meyers, Elham Shams, Ologibe Ofori, Assim Eddin and Marcelo L. G. Correia

The journal of clinical hypertension (Greenwich, Conn.), Vol.26(9), pp.1039-1044

09/2024

DOI: 10.1111/jch.14869

PMCID: PMC11488316

PMID: 39003579

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Abstract

Abstract There is conflicting evidence in select mouse models and humans that suggest angiotensin‐converting enzyme 2 expression is increased due to treatment with angiotensin converting enzyme inhibitors and angiotensin receptor blockers (ACEI/ARBs). Given the wide range of conditions that these medications treat, further evaluation is necessary to determine safety in the context of COVID‐19. We sought to determine the association between use of ACEI/ARBs and COVID‐19 severity in patients with essential hypertension. We included 714 patients with essential hypertension diagnosed with COVID‐19 and admitted to University of Iowa Healthcare from March 1, 2020 to June 29, 2021. Severity of COVID‐19 infection was assessed based on mortality, length of stay in hospital, intensive care unit admission, and use of supplemental oxygen, invasive ventilation, and vasopressors. Multivariable logistic and linear regression analyses were used for binary and continuous outcomes, respectively. Prior exposure to ACEI/ARBs before admission was significantly associated with lower mortality (OR: 0.454, p = .015), shorter length of stay in hospital ( p < .001), and decreased adjusted odds of intensive care admission (OR: 0.719; p < .042). The present results suggest that patients with essential hypertension hospitalized with COVID‐19 who had a prescription for ACEI/ARBs prior to admission exhibited less severe COVID‐19 and lower in‐hospital mortality.

Hypertension

ACE2

COVID-19

renin-angiotensin antagonism

UIOWA OA Agreement

Details

Title: Subtitle: Association between renin‐angiotensin antagonism and COVID‐19–related mortality in patients with essential hypertension: A single center, retrospective cohort study
Creators: Vijayvardhan Kamalumpundi - Mayo Clinic
Shuntaro Kawasaki - Division of Endocrinology and Metabolism University of Iowa Healthcare Iowa City Iowa USA
Linhai Cheng - University of Iowa
Erin E. Meyers - University of Iowa
Elham Shams - University of Iowa Health Care
Ologibe Ofori - University of Iowa Health Care
Assim Eddin - Division of Endocrinology and Metabolism University of Iowa Healthcare Iowa City Iowa USA
Marcelo L. G. Correia - Roy J. and Lucille A. Carver College of Medicine Iowa City Iowa USA, Division of Endocrinology and Metabolism University of Iowa Healthcare Iowa City Iowa USA
Resource Type: Journal article
Publication Details: The journal of clinical hypertension (Greenwich, Conn.), Vol.26(9), pp.1039-1044
DOI: 10.1111/jch.14869
PMID: 39003579
PMCID: PMC11488316
NLM abbreviation: J Clin Hypertens (Greenwich)
ISSN: 1524-6175
eISSN: 1751-7176
Publisher: Wiley
Language: English
Electronic publication date: 07/14/2024
Date published: 09/2024
Academic Unit: Endocrinology and Metabolism; Internal Medicine
Record Identifier: 9984657460202771

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