Updated Meta-Analysis: Do Cardiovascular Drugs Such as Antihypertensives and Anticoagulants Impact COVID-19 Outcomes?
BACKGROUND AND PURPOSE:
Cardiovascular drug exposure may modulate COVID-19 outcomes
Asiimwe et al. (British Journal of Clinical Pharmacology, 2022) update a previous systematic review and meta-analysis regarding cardiovascular drug exposure and COVID-19 clinical outcomes, with a focus on newly published randomized controlled trials
Systematic review and meta-analysis
Studies published after the baseline review that investigated the association between cardiovascular drug exposure and COVID-19 clinical outcomes
GRADE criteria to determine the strength of evidence
Subgroup analyses based on
Drug subclasses | Study quality (only studies with low risk of bias included) | Hypertension comorbidity (guided by earlier findings)
At risk of COVID-19
COVID-19 infectivity (defined as a positive COVID-19 diagnosis)
The most investigated drug classes were
Angiotensin-converting enzyme inhibitors were (ACEIs) and angiotensin receptor blocker (ARBs): 10 studies
Mean difference −0.42 (95% CI, −1.83 to 0.98) days; n = 1183
RR 0.90 (95% CI, 0.71 to 1.15); n = 1661
RR 0.92 (95% CI, 0.58 to 1.47); n = 1646
Therapeutic anticoagulation also had no effect
Mean difference −0.29 (95% CI, −1.13 to 0.56) days; n = 1449
RR 0.86 (95% CI, 0.70 to 1.04); n = 2696
RR 0.93 (95% CI, 0.77 to 1.13); n = 5689
Cardiovascular drugs like ACEIs, ARBs, and therapeutic anticoagulation do not appear to be associated with worse or better COVID-19 outcomes in randomized controlled trials
The authors state
As we wait for more evidence, we suggest that patients with COVID-19 on cardiovascular drugs should not discontinue taking them as it is very unlikely that these drugs, specifically ACEIs/ARBs, are harmful
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