ACE Inhibitors, ARBs, and COVID-19: Does Their Use Impact Length of Hospital Stay?
BACKGROUND AND PURPOSE:
Both beneficial and detrimental biochemical mechanisms have been proposed regarding the use of antihypertensive agents, due to the ACE-2 receptor involved with SARS-CoV-2 transmission
Braude et al. (Int J Cardiol Heart Vasc, 2020) examined the influence of angiotensin-converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARB) use on COVID-19 mortality and length of hospital stay
Prospective multicenter observational study (UK and Italy)
COPE (COVID-19 in Older People)
Adults of all ages admitted to the hospital with either laboratory or clinically confirmed COVID-19
7 day mortality
Length of hospital stay
1371 COVID-19 patients
Median age: 74 years (IQR 61 to 83)
Patients who were taking an ACEI or ARB: 28.6%
There was no effect of ACEI or ARB on inpatient mortality
Adjusted hazard ratio (aHR) 0.85 (95% CI, 0.65 to 1.11)
Patients who were prescribed an ACEI or ARB had significantly reduced hospital stays (p = 0.03)
aHR 1.25 (95% CI, 1.02 to 1.54)
This effect on hospital stay was even stronger among patients with hypertension (p = 0.007)
aHR 1.39 (95% CI, 1.09 to 1.77)
Continuing use of ACEI or ARBs does not have a negative impact on COVID-19 outcomes
Patients taking ACEI or ARBs may experience reduced length of hospital stay
These findings support professional guidance (e.g., European Society of Cardiology and the American College of Cardiology and the American Heart Association) to continue ACI and ARB therapy in patients with COVID-19
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Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
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presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
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