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Renin-angiotensin system inhibitors and susceptibility to COVID-19 in patients with hypertension: a propensity score-matched cohort study in primary care.
- Source :
-
BMC infectious diseases [BMC Infect Dis] 2021 Mar 15; Vol. 21 (1), pp. 262. Date of Electronic Publication: 2021 Mar 15. - Publication Year :
- 2021
-
Abstract
- Introduction: Renin-angiotensin system (RAS) inhibitors have been postulated to influence susceptibility to Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). This study investigated whether there is an association between their prescription and the incidence of COVID-19 and all-cause mortality.<br />Methods: We conducted a propensity-score matched cohort study comparing the incidence of COVID-19 among patients with hypertension prescribed angiotensin-converting enzyme I (ACE) inhibitors or angiotensin II type-1 receptor blockers (ARBs) to those treated with calcium channel blockers (CCBs) in a large UK-based primary care database (The Health Improvement Network). We estimated crude incidence rates for confirmed/suspected COVID-19 in each drug exposure group. We used Cox proportional hazards models to produce adjusted hazard ratios for COVID-19. We assessed all-cause mortality as a secondary outcome.<br />Results: The incidence rate of COVID-19 among users of ACE inhibitors and CCBs was 9.3 per 1000 person-years (83 of 18,895 users [0.44%]) and 9.5 per 1000 person-years (85 of 18,895 [0.45%]), respectively. The adjusted hazard ratio was 0.92 (95% CI 0.68 to 1.26). The incidence rate among users of ARBs was 15.8 per 1000 person-years (79 out of 10,623 users [0.74%]). The adjusted hazard ratio was 1.38 (95% CI 0.98 to 1.95). There were no significant associations between use of RAS inhibitors and all-cause mortality.<br />Conclusion: Use of ACE inhibitors was not associated with the risk of COVID-19 whereas use of ARBs was associated with a statistically non-significant increase compared to the use of CCBs. However, no significant associations were observed between prescription of either ACE inhibitors or ARBs and all-cause mortality.
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Angiotensin Receptor Antagonists adverse effects
Angiotensin-Converting Enzyme Inhibitors adverse effects
Antihypertensive Agents adverse effects
COVID-19 mortality
Calcium Channel Blockers adverse effects
Cohort Studies
Female
Humans
Incidence
Male
Middle Aged
Mortality
Propensity Score
Proportional Hazards Models
Renin-Angiotensin System
United Kingdom
Young Adult
Angiotensin Receptor Antagonists therapeutic use
Angiotensin-Converting Enzyme Inhibitors therapeutic use
Antihypertensive Agents therapeutic use
COVID-19 complications
Calcium Channel Blockers therapeutic use
Hypertension complications
Hypertension drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1471-2334
- Volume :
- 21
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- BMC infectious diseases
- Publication Type :
- Academic Journal
- Accession number :
- 33722197
- Full Text :
- https://doi.org/10.1186/s12879-021-05951-w