Are ACE Inhibitors and ARBs Associated with Increased COVID-19 Susceptibility?
BACKGROUND AND PURPOSE:
Hippisley-Cox et al. (Heart, 2020) used a large population study to investigate whether there is an association between ACE inhibitors and ARBs and COVID-19 disease susceptibility and progression
Prospective cohort study
General practices in England
Adults aged 20 to 99 years
ACE inhibitors and ARB drugs
Cox proportional hazards models were used to derive adjusted hazard ratio
Results adjusted for confounders such as sociodemographic factors, concurrent medications and geographical region
RT-PCR confirmed COVID-19
COVID-19 that resulted in ICU care
19,486 patients had COVID-19
Received ICU care: 1286
ACE inhibitors and ARBs were associated with a significantly reduced risk of COVID-19
Adjusted HR 0.71 (95% CI, 0.67 to 0.74)
Adjusted HR 0.63 (95% CI, 0.59 to 0.67)
Neither ACE inhibitors nor ARBS were associated with an increased risk of ICU care
Adjusted HR 0.89 (95% CI, 0.75 to 1.06)
Adjusted HR 1.02 (95% CI, 0.83 to 1.25)
The risk of COVID-19 disease associated with ACE inhibitors was higher in Caribbean and Black African groups vs white group | The risk of COVID-19 disease associated with ARBs was higher in the Black African group vs the white group
ACE inhibitors and ARBs were associated with a reduced risk of COVID-19
ACE inhibitors and ARBS was not associated with an increased risk of ICU care
The authors state
Variations between different ethnic groups raise the possibility of ethnic-specific effects of ACE inhibitors/ARBs on COVID-19 disease susceptibility and severity which deserves further study
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