1. Renin-angiotensin system inhibitors effect before and during hospitalization in COVID-19 outcomes: Final analysis of the international HOPE COVID-19 (Health Outcome Predictive Evaluation for COVID-19) registry
- Author
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Martino Pepe, Rodolfo Romero, Francisco Marín, Álvaro López-Masjuan, Juan García-Prieto, Marcos García-Aguado, Javier Elola, Antonio Fernández-Ortiz, Hope Covid Investigators, Carolina Espejo, Sergio Raposeiras-Roubín, Víctor Manuel Becerra-Muñoz, Christoph Liebetrau, Ivan Olier, Carlos Macaya, Jorge Luis Jativa Mendez, Charbel Maroun-Eid, Elvira Bondia, Alex F Castro-Mejía, Enrico Cerrato, Adelina Gonzalez, Javier López-Pais, Inmaculada Fernández-Rozas, Aitor Uribarri, Fabrizio Ugo, Harish Ramakrishna, Iván J. Núñez-Gil, María C Viana-Llamas, Mohammad Abumayyaleh, Miguel Corbí-Pascual, Gisela Feltes, Emilio Alfonso-Rodríguez, and Vicente Estrada
- Subjects
QA75 ,Male ,medicine.medical_specialty ,Heart disease ,Infecciones por coronavirus ,medicine.medical_treatment ,Inhibidores enzimáticos ,Population ,Clinical Investigations ,Enfermedad transmisible ,Angiotensin-Converting Enzyme Inhibitors ,Sistema renina-angiotensina ,Comorbidity ,030204 cardiovascular system & hematology ,Severity of Illness Index ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Outcome Assessment, Health Care ,Severity of illness ,medicine ,Humans ,Registries ,030212 general & internal medicine ,Medical prescription ,education ,Heart Failure ,Mechanical ventilation ,education.field_of_study ,SARS-CoV-2 ,business.industry ,COVID-19 ,Middle Aged ,Prognosis ,medicine.disease ,R1 ,Respiration, Artificial ,Hospitalization ,Italy ,Spain ,Heart failure ,Emergency medicine ,Female ,Observational study ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background The use of Renin-Angiotensin system inhibitors (RASi) in patients with coronavirus disease 2019 (COVID-19) has been questioned because both share a target receptor site. Methods HOPE-COVID-19 (NCT04334291) is an international investigator-initiated registry. Patients are eligible when discharged after an in-hospital stay with COVID-19, dead or alive. Here, we analyze the impact of previous and continued in-hospital treatment with RASi in all-cause mortality and the development of in-stay complications. Results We included 6503 patients, over 18 years, from Spain and Italy with data on their RASi status. Of those, 36.8% were receiving any RASi before admission. RASi patients were older, more frequently male, with more comorbidities and frailer. Their probability of death and ICU admission was higher. However, after adjustment, these differences disappeared. Regarding RASi in-hospital use, those who continued the treatment were younger, with balanced comorbidities but with less severe COVID19. Raw mortality and secondary events were less frequent in RASi. After adjustment, patients receiving RASi still presented significantly better outcomes, with less mortality, ICU admissions, respiratory insufficiency, need for mechanical ventilation or prone, sepsis, SIRS and renal failure (p
- Published
- 2021
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