期刊
EUROPEAN JOURNAL OF HEART FAILURE
卷 22, 期 6, 页码 967-974出版社
WILEY
DOI: 10.1002/ejhf.1924
关键词
COVID-19; Angiotensin-converting enzyme inhibitors; Hypertension; Disease outcome
资金
- UKRI Innovation Fellowship (Health Data Research UK) [MR/S00310X/1]
- King's College London UK Medical Research Council (MRC) Skills Development Fellowship programme [MR/R016372/1]
- National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London (SLAM-KCL) [IS-BRC-1215-2001]
- NIHR Biomedical Research Centre at SLAM-KCL [IS-BRC-1215-20018]
- NIHR centre at University College London Hospitals
- BigData@Heart Consortium - Innovative Medicines Initiative-2 Joint Undertaking under the European Union Horizon 2020 programme [116074]
- NIHR University College London Hospitals Biomedical Research Centre
- NIHR Biomedical Research Centre at SLAM-KCL
- UK Research and Innovation London Medical Imaging & Artificial Intelligence Centre for Value Based Healthcare
- National Institute for Health Research (NIHR) Applied Research Collaboration South London (NIHR ARC South London) at King's College Hospital NHS
- MRC Clinical Training Fellowship
- King's Prize Fellowship
- King's Medical Research Trust studentship
- British Heart Foundation [CH/1999001/11735]
- NIHR Biomedical Research Centre at Guy's & St Thomas' NHS Foundation Trust and King's College London [IS-BRC-1215-20006]
- Fondation Leducq
- NIHR [NF-SI-0617-10120]
- NIHR University College London Hospitals Biomedical Research Centre Clinical and Research Informatics Unit
- NIHR Health Informatics Collaborative
- Institute of Health Informatics at University College London
- Health Data Research UK
- National Institutes of Health Research (NIHR) [IS-BRC-1215-20006] Funding Source: National Institutes of Health Research (NIHR)
- MRC [MC_PC_17214] Funding Source: UKRI
Aims The SARS-CoV-2 virus binds to the angiotensin-converting enzyme 2 (ACE2) receptor for cell entry. It has been suggested that angiotensin-converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB), which are commonly used in patients with hypertension or diabetes and may raise tissue ACE2 levels, could increase the risk of severe COVID-19 infection. Methods and results We evaluated this hypothesis in a consecutive cohort of 1200 acute inpatients with COVID-19 at two hospitals with a multi-ethnic catchment population in London (UK). The mean age was 68 +/- 17 years (57% male) and 74% of patients had at least one comorbidity. Overall, 415 patients (34.6%) reached the primary endpoint of death or transfer to a critical care unit for organ support within 21 days of symptom onset. A total of 399 patients (33.3%) were taking ACEi or ARB. Patients on ACEi/ARB were significantly older and had more comorbidities. The odds ratio for the primary endpoint in patients on ACEi and ARB, after adjustment for age, sex and co-morbidities, was 0.63 (95% confidence interval 0.47-0.84,P < 0.01). Conclusions There was no evidence for increased severity of COVID-19 in hospitalised patients on chronic treatment with ACEi or ARB. A trend towards a beneficial effect of ACEi/ARB requires further evaluation in larger meta-analyses and randomised clinical trials.
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