open access

Vol 26, No 1 (2022)
Original paper
Published online: 2022-03-31
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COVID-19 clinical outcomes in patients with and without ongoing therapy with angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers

Ahmed Nafakhi1, Ihsan Rabeea2, Rasha AL-Darraji1, Hussein Nafakhi3, Ahmed Mechi3, Alhan Al-khalidi4
DOI: 10.5603/AH.a2022.0005
·
Arterial Hypertension 2022;26(1):9-14.
Affiliations
  1. Najaf Health Bureau, Ministry of Health, Iraq
  2. University of Kufa, Pharmacy College, Najaf, Iraq
  3. University of Kufa, Medicine College, Najaf, Iraq
  4. Jabir Ibn Hayan Medical University, Najaf, Iraq

open access

Vol 26, No 1 (2022)
ORIGINAL PAPERS
Published online: 2022-03-31

Abstract

Background: The are conflicting reports on the effects of angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II receptor blockers (ARB) continued treatment on clinical outcomes in COVID-19 patients.

Material and methods: Patients presented with symptoms suggestive of COVID-19 infection were enrolled between 5 April 2021,and 5 June 2021. Patients who survived acute stage of the disease were asked to attend out-patient clinic after six months following COVID-19 infection diagnosis.

Results: A total of 162 patients were enrolled in this study. ARB users showed significant independent association with lower fatality rate as compared to ACEI/ARB-naïve patients [OR (CI) = 0.1(0.0–0.5), p = 0.01]. The prevalence of respiratory support use and intensive care unit (ICU) admission was numerically, but not statically significant, lower among ARB users than non-ARB users. The distribution of in-hospital adverse outcome was numerically lower among ACEI users than in non ACEI users, though the association did not reach statistical significance. ARB users showed significant independent association with persistent cough [OR (CI) = 2 (1.1–10), p = 0.02]. No significant differences in other long term symptoms were found between ARB users and nonusers. On the other hand, chest pain showed higher prevalence among ACEI users than in non-ACEI users. After adjusting for baseline comorbidities, chest pain association with ACEI user was not persisted. No significant differences in other long term symptoms were found between ACEI users and nonusers.

Conclusion: ARB and ACEI users showed low prevalence of in-hospital adverse outcome compared to ARB/ACEI nonusers. ARB showed significant and independent association with persistent cough.

Abstract

Background: The are conflicting reports on the effects of angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II receptor blockers (ARB) continued treatment on clinical outcomes in COVID-19 patients.

Material and methods: Patients presented with symptoms suggestive of COVID-19 infection were enrolled between 5 April 2021,and 5 June 2021. Patients who survived acute stage of the disease were asked to attend out-patient clinic after six months following COVID-19 infection diagnosis.

Results: A total of 162 patients were enrolled in this study. ARB users showed significant independent association with lower fatality rate as compared to ACEI/ARB-naïve patients [OR (CI) = 0.1(0.0–0.5), p = 0.01]. The prevalence of respiratory support use and intensive care unit (ICU) admission was numerically, but not statically significant, lower among ARB users than non-ARB users. The distribution of in-hospital adverse outcome was numerically lower among ACEI users than in non ACEI users, though the association did not reach statistical significance. ARB users showed significant independent association with persistent cough [OR (CI) = 2 (1.1–10), p = 0.02]. No significant differences in other long term symptoms were found between ARB users and nonusers. On the other hand, chest pain showed higher prevalence among ACEI users than in non-ACEI users. After adjusting for baseline comorbidities, chest pain association with ACEI user was not persisted. No significant differences in other long term symptoms were found between ACEI users and nonusers.

Conclusion: ARB and ACEI users showed low prevalence of in-hospital adverse outcome compared to ARB/ACEI nonusers. ARB showed significant and independent association with persistent cough.

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Keywords

COVID-19; ARB; ACEI; outcome; long term

About this article
Title

COVID-19 clinical outcomes in patients with and without ongoing therapy with angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers

Journal

Arterial Hypertension

Issue

Vol 26, No 1 (2022)

Article type

Original paper

Pages

9-14

Published online

2022-03-31

Page views

234

Article views/downloads

47

DOI

10.5603/AH.a2022.0005

Bibliographic record

Arterial Hypertension 2022;26(1):9-14.

Keywords

COVID-19
ARB
ACEI
outcome
long term

Authors

Ahmed Nafakhi
Ihsan Rabeea
Rasha AL-Darraji
Hussein Nafakhi
Ahmed Mechi
Alhan Al-khalidi

References (13)
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  4. Fadini GP, Morieri ML, Boscari F, et al. Newly-diagnosed diabetes and admission hyperglycemia predict COVID-19 severity by aggravating respiratory deterioration. Diabetes Res Clin Pract. 2020; 168: 108374.
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  10. Baral R, Tsampasian V, Debski M, et al. Association Between Renin-Angiotensin-Aldosterone System Inhibitors and Clinical Outcomes in Patients With COVID-19: A Systematic Review and Meta-analysis. JAMA Netw Open. 2021; 4(3): e213594.
  11. Zhang P, Zhu L, Cai J, et al. Association of Inpatient Use of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers With Mortality Among Patients With Hypertension Hospitalized With COVID-19. Circ Res. 2020; 126(12): 1671–1681.
  12. Huang L, Chen Z, Ni L, et al. Impact of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers on the Inflammatory Response and Viral Clearance in COVID-19 Patients. Front Cardiovasc Med. 2021; 8: 710946.
  13. Wu C, Qu G, Wang L, et al. Clinical Characteristics and Inflammatory Immune Responses in COVID-19 Patients With Hypertension: A Retrospective Study. Front Pharmacol. 2021; 12: 721769.

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