Abstract 16726: Impact of Angiotensin Converting Enzyme Inhibitors/angiotensin Receptor Blockers on Mortality and Severity of Covid-19 Pneumonia

Abstract

Introduction: Coronaviruses are a large family of viruses that have been around for many years and may cause illness in humans or animals. In early December 2019, the first pneumonia cases related to the coranoavirus were found which has since led a pandemic. Coronaviruses bind to their target cells through angiotensin-converting enzyme 2 (ACE2), which is expressed by epithelial cells of the lung, intestine, kidney, and blood vessels. Hypothesis: Hypothetically, the increased expression of ACE2 would facilitate infection with COVID-19 and treatment with ACE2-stimulating drugs may worsen the infection with COVID-19. The goal of this study was to analyze the severity of COVID-19 in patients who are on ACEi and ARB therapy. Methods: All adult patients admitted with the confirmed diagnosis of COVID 19 pneumonia between March to April 2020 in our community hospital were included in the study. Patients were then be divided into two groups, one group who received ACEi or ARBs and a second group who did not. The baseline characteristics of two groups were compared. Primary outcome was the in-hospital mortality between two groups. Secondary outcomes were severity of pneumonia including rate of intubation, requirement for ICU admission and total length of hospital stay. Results: A total of 200 patients were admitted with the time frame studied. After removing for missing data 194 patients were included in the study of which 64 patients received either ACEi or ARB during the hospital stay. There was no difference in the rate of inpatient mortality in patients who received or did not received the drug (32.3% vs 23.5% p- value 0.19). Similarly, there was no difference in the other outcomes including rate of intubation(22.6% vs 24.4% p- value 0.79), requirement for ICU admission(21% vs 33.3% p-value 0.07) and mean total length of hospital stay between the two groups (9.5 days vs 8.4 days p-value 0.34). Conclusion: There was no difference in the outcomes. Patients who received ACEi or ARBs did not have worse outcomes. Thus, if indicated for other reasons, these drugs can safely be continued in patients with COVID 19 pneumonia. Further large center studies are however, required to confirm our findings.