Renin-Angiotensin-Aldosterone System Inhibitors and Risk of Covid-19.
Background: There is concern about the potential of an increased risk related to medications that act on the renin-angiotensin-aldosterone system in patients exposed to coronavirus disease 2019 (Covid-19), because the viral receptor is angiotensin-converting enzyme 2 (ACE2).Methods: We assessed the...
| Publicado en: | New England Journal of Medicine Vol. 382; no. 25; pp. 2441 - 2449 |
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| Autores principales: | , , , , , , , , , , , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
New England Journal of Medicine
7/18/2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=143820594&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 143820594 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00284793 NEJ jtl: New England Journal of Medicine issn: 00284793 maglogo: N pubinfo: dt: 7/18/2020 vid: 382 iid: 25 pid: 388 pub: New England Journal of Medicine place: Waltham, Massachusetts artinfo: ui: 143820594 143820594 NLM32356628 10.1056/NEJMoa2008975 NLM32356628 143820594 ppf: 2441 ppct: 8 formats: tig: atl: Renin-Angiotensin-Aldosterone System Inhibitors and Risk of Covid-19. aug: au: Reynolds, Harmony R. Adhikari, Samrachana Pulgarin, Claudia Troxel, Andrea B. Iturrate, Eduardo Johnson, Stephen B. Hausvater, Anai's Newman, Jonathan D. Berger, Jeffrey S. Bangalore, Sripal Katz, Stuart D. Fishman, Glenn I. Kunichoff, Dennis Yu Chen Ogedegbe, Gbenga Hochman, Judith S. Hausvater, Anaïs Chen, Yu affil: New York University (NYU) Grossman School of Medicine, New York sug: subj: Angiotensin-Converting Enzyme Inhibitors Administration and Dosage COVID-19 Epidemiology Diuretics, Thiazide Administration and Dosage Adrenergic beta-Antagonists Administration and Dosage Angiotensin II Type I Receptor Blockers Administration and Dosage Calcium Channel Blockers Administration and Dosage Pneumonia, Viral Epidemiology Risk Factors Adult Angiotensin-Converting Enzyme Inhibitors Adverse Effects New York Male Middle Age Disease Outbreaks Aged Hypertension Complications Calcium Channel Blockers Adverse Effects Antihypertensive Agents Adverse Effects Antihypertensive Agents Administration and Dosage Female Diuretics, Thiazide Adverse Effects Probability Adrenergic beta-Antagonists Adverse Effects Angiotensin II Type I Receptor Blockers Adverse Effects Renin-Angiotensin System Drug Effects Psychological Tests Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Background: There is concern about the potential of an increased risk related to medications that act on the renin-angiotensin-aldosterone system in patients exposed to coronavirus disease 2019 (Covid-19), because the viral receptor is angiotensin-converting enzyme 2 (ACE2).Methods: We assessed the relation between previous treatment with ACE inhibitors, angiotensin-receptor blockers, beta-blockers, calcium-channel blockers, or thiazide diuretics and the likelihood of a positive or negative result on Covid-19 testing as well as the likelihood of severe illness (defined as intensive care, mechanical ventilation, or death) among patients who tested positive. Using Bayesian methods, we compared outcomes in patients who had been treated with these medications and in untreated patients, overall and in those with hypertension, after propensity-score matching for receipt of each medication class. A difference of at least 10 percentage points was prespecified as a substantial difference.Results: Among 12,594 patients who were tested for Covid-19, a total of 5894 (46.8%) were positive; 1002 of these patients (17.0%) had severe illness. A history of hypertension was present in 4357 patients (34.6%), among whom 2573 (59.1%) had a positive test; 634 of these patients (24.6%) had severe illness. There was no association between any single medication class and an increased likelihood of a positive test. None of the medications examined was associated with a substantial increase in the risk of severe illness among patients who tested positive.Conclusions: We found no substantial increase in the likelihood of a positive test for Covid-19 or in the risk of severe Covid-19 among patients who tested positive in association with five common classes of antihypertensive medications. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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