Impact of angiotensin receptor blocker as antihypertensive in assessing mortality in patients of COVID-19: A single tertiary care center study

Abstract

BACKGROUND: The angiotensin-converting enzyme 2 (ACE2) receptor, a membrane receptor present in the respiratory system, the gastrointestinal tracts, the heart, and the kidney is the entry point for SARS-CoV-2 to enter human cells. Concerns were raised about the influence of using antihypertensive drugs like angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) in individuals with COVID-19 due to its tight relationship with the ACE2 receptor. The aim of this study was to investigate the impact of being on an Angiotensin Receptor Blockers (ARB) on mortality in patients consecutively diagnosed with COVID-19. MATERIAL AND METHODS: This is the retrospective observational study done in all patients consecutively diagnosed with COVID-19 from January 2021 to June 2021. All related patient information and clinical data was retrieved from the hospitals electronic medical record system. RESULTS: In this study, out of 500 patients, 51 died, having mean age of 66.92 ± 10.85 years. 144 (28.8%) patients were on angiotensin receptor blockers as antihypertensive treatment, 142 (28.4%) having other antihypertensive and 214 (42.8%) were not on any treatment. Out of 51 Death 7 (4.9) patients were on ARBs, 15 ± 10.6 were on other medication [OR 2.31 (0.94–6.22, P = 0.077) univariable; OR 2.57 (1.00–7.23, P = 0.058) multivariable] and 29 ± 13.6 had no treatment at all [OR 3.07 (1.38–7.80, P = 0.010) univariable; OR 3.36 (1.41–9.08, P = 0.010) multivariable]. CONCLUSION: Use of ARB medications for the hypertensive patients who acquire COVID-19 infection has shown protective effects of such medications on COVID-19 disease severity in the term of mortality and the mortality rate among hypertensive patients on COVID-19 with ARBs/ACE inhibitors showed significant differences as compared to other antihypertensives.

Factors Associated with Pneumonia in Patients Hospitalized with COVID-19 and the Role of Vaccination

“…This result is not surprising since all hypertensive patients in the present cohort were receiving therapy with angiotensin-converting enzyme inhibitors. A recent study on the use of ACE inhibitors for hypertensive patients with COVID-19 infection showed the protective effects of these drugs on the severity of the disease in terms of mortality, highlighting that in this group of patients, there was less disease severity and a reduced risk of admission to intensive care [ 64 ].…”

“…Nor did we assess some potential confounding factors, such as previous SARS-CoV-2 infection or time between the data of vaccination and the onset of disease. Moreover, it would have been interesting to consider the effects of the restrictive measures, the risk management, and the communication plans implemented by the government during the pandemic [ 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 ].…”

Nonlinear Relationship Between Interleukin-6 and NT-proBNP at Admission in Hospitalized COVID-19 Patients

“…4, Because we excluded patients with a history of heart failure, the findings of this study cannot be applied to these patients. 5, Due to the nature of our cross-sectional study on admission data, information regarding the utilization of angiotensin receptor blockers, 29 which may affect NT-proBNP and mortality, is currently unavailable. However, we intend to delve deeper into this aspect through future investigations.…”