Effect Of Angiotensin-Converting Enzyme Inhibitors And Angiotensin Receptor Blockers On the Clinical Outcome In COVID-19 Patients With Hypertension

authors:

avatar Zahra Fakhrae , * , avatar Saeid Bitaraf , avatar Roohangize Nashibi , avatar Fatemeh Ahmadi , avatar Safoura Khosravi 1 , avatar Shokrollah Salmanzadeh ORCID 2

School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Department of Infectious Diseases, School of Medicine, Infectious and Tropical Diseases Research Center, Health Research Institute, Razi Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Journal of Cellular & Molecular Anesthesia: Vol.6, issue 4; e149739
published online: October 19, 2021
article type: Original Articles
DOI: https://doi.org/10.22037/jcma.v6i4.35596

how to cite: Fakhrae Z, Bitaraf S, Nashibi R, Ahmadi F, Khosravi S, et al. Effect Of Angiotensin-Converting Enzyme Inhibitors And Angiotensin Receptor Blockers On the Clinical Outcome In COVID-19 Patients With Hypertension. J Cell Mol Anesth. 2021;6(4):e149739. https://doi.org/10.22037/jcma.v6i4.35596.

Abstract

Background: Hypertension is the main factor to predict the severity and mortality of COVID-19. 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-19 patients with hypertension. Materials and Methods: This cross-sectional study was carried out on 498 patients who were referred to Razi hospital following COVID-19 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<0.001). One hundred eleven deaths (22.3%) were seen in the studied patients in whom 66 deaths (59.5%) belonged to the group not taking ACEIs and ARBs (p>0.05). Seventy-nine patients (15.86%) were admitted to ICU in which 62.03% of these patients died while the non-ICU mortality rate was 14.8% (Odds Ratio = 9.40; 95% CI: 5.54 to 15.95, p <0.001). A subgroup analysis found that among patients with diabetes who had hypertension, the incidence of death was 43.55% in the group taking ARBs/ACEi lower than in another group significant (p = 0.021). Conclusion: The mortality rate in the patients taking ACEIs/ARBs is not different from other groups. It was found that among COVID-19 patients with diabetes who had hypertension, the incidence of death in the patients taking ARBs/ACEi was lower than in another group.

References

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    References are in the PDF file of the article.