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BACKGROUND: There is a growing concern about the potential harmful effects of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) in patients with COVID-19 and cardiovascular diseases (CVDs). The aim of this study was to evaluate the association between recent exposure to ACEIs/ARBs and in-hospital mortality in patients with COVID-19. METHODS: We used the data from a nationwide cohort of patients with COVID-19 from the health insurance claims data of South Korea, which were released for research purposes for public health by the Ministry of Health and Welfare of South Korea. Patients with COVID-19 were identified using the relevant diagnostic code. Propensity score-matching (1:1) was carried out among patients with CVD according to the type of medication (ACEIs/ARBs vs. other), and the risk of death was assessed. RESULTS: A total of 4936 patients with COVID-19 were analyzed, of whom 1048 (21.2%) had CVD. Of the 1048 patients with CVD, 864 (82.4%) received at least one anti-hypertensive medication prior to the diagnosis of COVID-19, including 359 (41.6%) who received ACEIs/ARBs and 505 (58.4%) who received drugs other than ACEIs/ARBs. Using the propensity scores for ACEIs/ARBs use, we matched 305 pairs of patients receiving ACEIs/ARBs and patients receiving other drugs. The recent use of ACEIs/ARBs was not significantly associated with in-hospital mortality in unadjusted analysis (odds ratio [OR], 0.62; 95% CI, 0.33 to 1.14) and propensity score-matching analysis (OR, 1.00; 95% CI, 0.46 to 2.16). CONCLUSION: In patients with COVID-19 and underlying CVDs, the recent use of ACEIs/ARBs was not significantly associated with in-hospital mortality. These findings do not support stopping or modifying ACEIs/ARBs in patients amidst the current COVID-19 pandemic.
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document_parses/pdf_json/061d7cd5c712acb908b430b96ea64fcda4e7861a.json
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Effects of Recent Use of Renin-Angiotensin System Inhibitors on Mortality of Patients with Coronavirus Disease 2019
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