Impact of antihypertensive agents on clinical course and in-hospital mortality: analysis of 169 hypertensive patients hospitalized for COVID-19

Abstract

SUMMARY OBJECTIVE Coronavirus disease 2019 (COVID-19) is an emerging health threat caused by a novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-COV-2). Previous studies have noted hypertension is associated with increased mortality due to COVID-19; however, it is not clear whether the increased risk is due to hypertension itself or antihypertensive agents. We aimed to evaluate the impact of antihypertensive agents on the clinical outcomes of hypertensive patients with COVID-19. METHODS Our study included 169 consecutive hypertensive patients hospitalized due to COVID-19 between March 20 and April 10, 2020. The demographic characteristics, clinical data, and type of antihypertensive agents being used were reviewed. RESULTS The mean age of patients was 65.8±11.7 years.30 patients(17.7%) died during hospitalization. A total of 142 patients(84%) were using angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs), 91 (53.8%) were using diuretics, 69 (40.8%) were using calcium channel blockers (CCBs), 66 (39.1%) were using beta-blockers, 12 (7.1%) were using alpha-blockers, and 5 (2.9%) were using mineralocorticoid receptor antagonists (MRAs). There was no significant difference between survivors and non-survivors based on the type of antihypertensive agents being used. Binary logistic regression analysis showed that the type of the antihypertensive agent being used had no effect on mortality [OR=0.527 (0.130-2.138), p=0.370 for ACEIs/ARBs; OR=0.731 (0.296-1.808), p=0.498 for CCBs; OR=0.673 (0.254-1.782), p=0.425 for diuretics; OR=1.846 (0.688-4.950), p=0.223 for beta-blockers; OR=0.389 (0.089-1.695), p=0.208 for alpha-blockers; and OR=1.372 (0.107-17.639), p=0.808 for MRAs]. CONCLUSION The type of antihypertensive agent being used had no effect on the clinical course and mortality in hypertensive patients with COVID-19. The use of these agents should be maintained for the treatment of hypertension during hospitalization.

A comprehensive guide to the pharmacologic regulation of angiotensin converting enzyme 2 (ACE2), the SARS-CoV-2 entry receptor

“…In recent months, several clinical studies have reported that the use of ARBs and ACE-Inhs. does not affect disease progression and mortality rates in COVID-19 patients ( Anzola et al, 2020 ; Bae et al, 2020 ; Braude et al, 2020 ; Cordeanu et al, 2020 ; H. Cui et al, 2020 ; Di Castelnuovo et al, 2020 ; Gormez et al, 2020 ; Hippisley-Cox et al, 2020 ; Kalra et al, 2020 ; Khan et al, 2020 , Kim et al, 2020 ; Kocayigit et al, 2020 ; Lafaurie et al, 2020 ; J. Lee et al, 2020 ; Sardu et al, 2020 ; Soleimani et al, 2020 , Taher et al, 2020 ; Trifirò et al, 2020 , Wang et al, 2020 ). Altogether, these results indicate that the use of ACE-Inhs.…”

Association of calcium channel blocker use with clinical outcome of COVID-19: A meta-analysis

“…Twenty-seven studies were retrospective, and four studies were prospective observational. Twenty-two studies have already been undergone peer-review [ 9 , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] ]. Most studies were conducted in China and Italy.…”

In the SARS-CoV-2 Pandora Pandemic: Can the Stance of Premorbid Intestinal Innate Immune System as Measured by Fecal Adnab-9 Binding of p87:Blood Ferritin, Yielding the FERAD Ratio, Predict COVID-19 Susceptibility and Survival in a Prospective Population Database?

“…Whether this influenced the response to COVID-19 remains unknown. CCB treatment, which has antiviral activity [33,34], could be a suitable alternative for some, but not all, conditions for which these agents were prescribed. The benefit-to-harm ratio of continuing to take ACE-I or ARB, which are effective in the treatment and prevention of substantial cardiovascular, diabetic, and renal morbidity and mortality, should be addressed by a comprehensive epidemiological study utilizing reliable available data.…”