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?:abstract
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AIM: ACE2 is the receptor for SARS-CoV-2 Animal studies suggest that RAAS blockers might increase the expression of ACE2 and potentially increase the risk of SARS-Cov-2 infection METHODS AND RESULTS: The effect of ACE inhibitor (ACEi) treatment on the pneumonia incidence in non-COVID-19 patients (25 studies, 330,780 patients) was associated with a 26% reduction of pneumonia risk (OR: 0 74, p<0 001) Pneumonia related death cases in ACEi treated non-COVID-19 patients were reduced by 27% (OR: 0 73, p=0 004) However, ARB treatment (10 studies, 275,621 non-COVID-19 patients) did not alter pneumonia risk in patients Pneumonia related death cases in ARBs treated non-COVID-19 patients was analysed only in one study and was significantly reduced (OR, 0 47;95% CI, 0 30 to 0 72) Results from 11 studies (8 4 million patients) showed that the risk of getting infected with the SARS-CoV-2 virus was reduced by 13% (OR: 0 87, p=0 014) in patients treated with ACEi, whereas analysis from 10 studies (8 4 million patients) treated with ARBs showed no effect (OR, 0 92, p=0 354) Results from 34 studies in 67,644 COVID-19 patients showed that RAAS blockade reduces all-cause mortality by 24% (OR=0 76, p=0 04) CONCLUSION: ACEi reduces the risk of getting infected with the SARS-CoV-2 virus Blocking the RAAS may decrease all cause mortality in COVID-19 patients ACE inhibitors do reduce the risk of non-COVID pneumonia All cause mortality due to non-COVID pneumonia is reduced by ACEi and potentially by ARBs
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