Journal
CLINICAL INFECTIOUS DISEASES
Volume 72, Issue 11, Pages E901-E913Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/cid/ciaa1592
Keywords
COVID-19; cardiovascular disease; angiotensin-converting enzyme inhibitor; angiotensin receptor blocker; meta-analysis
Categories
Funding
- National Key Research and Development Program of China [2020YFC0861000]
- Major Projects of National Science and Technology on New Drug Creation and Development [2020ZX09201001, 2020ZX09201012]
- Chinese Academy of Medical Sciences (CAMS) Emergency Project of COVID-19 [2020HY320001]
- CAMS Innovation Fund for Medical Sciences [2020-I2M-CoV19-001]
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The study found no association between prior use of ACEI/ARB and the risk of COVID-19 infection, and using ACEI/ARB did not change the severity of the disease among patients. This suggests that the current medical guidelines and position statements supporting the continuation of ACEI/ARB use are evidence-based and appropriate.
There have been arguments on whether angiotensin-converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) treatment alters the risk of coronavirus disease 2019 (COVID-19) susceptibility and disease severity. We identified a total of 102 eligible studies for systematic review, in which 49 studies adjusting for confounders were included in the meta-analysis. We found no association between prior ACEI/ARB use and risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the general population (adjusted odds ratio [aOR], 1.00; 95% confidence interval [CI], .94-1.05). 'I he risk of mortality (aOR, .87; 95% CI, .66-1.04) and severe outcomes (aOR, .95; 95% CI, .73-1.24) were also unchanged among COVID-19 patients taking ACEIs/ARBs. These findings remained consistent in subgroup analyses stratified by populations, drug exposures, and other secondary outcomes. This systematic review provides evidence-based support to current medical guidelines and position statements that ACEIs/ARBs should not be discontinued. Additionally, there has been no evidence for initiating ACEI/ARB regimen as prevention or treatment of COVID-19.
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