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?:abstract
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BACKGROUND Role of antihypertensive, especially Renin-Angiotensin-Aldosterone System (RAAS) inhibitors are still debatable in COVID-19 related severity and outcome. Therefore, we search for a more global analysis of antihypertensive medication in relation to SAS-CoV-2 severity using prescription data worldwide. METHODS Association between percentage use of different types of anti-hypertensive medications and mortality rates due to a SARS-CoV-2 infection during the first three weeks of the pandemic were analyzed using random effects linear regression models for 30 countries worldwide. RESULT Both a higher percentages of prescribed angiotensin receptor blockers (ARBs) [β, 95% CI; -0.02(-0.04- -0.0012); p=0.042] and calcium channel blockers (CCB) [β, 95% CI; -0.023 (-0.05- -0.0028); p=0.0304] were associated with a lower first 3-week SARS-CoV-2 related death rate, whereas higher percentages of prescribed angiotensin converting enzyme inhibitors (ACEi) [β, 95% CI; 0.03 (0.0061-0.05); p=0.0103] was associated with a higher first 3-week death rate, even when adjusted for age and metformin use. There was no association of the amount of prescribed beta blockers (BB) and diuretics (Diu) and first 3-week death rate. When analyzing which combination of drugs are used by at least 50% of antihypertensive users, within the different countries, countries with the lowest first 3-week death rates all had at least an angiotensin receptor blocker as one of the most often prescribed antihypertensive medications ( (ARBs)/ (CCB) (β, 95% CI; -0.02 (-0.03- -0.004); p=0.009), ARBs/ (BB) (β, 95% CI; -0.03 (-0.05- -0.006); p=0.01)). Finally, countries prescribing high potency ARB\'s, had lower first 3-week death rates than countries prescribing low potency ARB\'s. CONCLUSION In conclusion ARBs and CCB seems to have protective effect from dying with SARS-CoV-2 infection. This article is protected by copyright. All rights reserved.
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