ASSOCIATION OF IN-PATIENT OUTCOMES AND RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM INHIBITOR USE AMONG HYPERTENSIVE PATIENTS WITH CORONAVIRUS DISEASE 2019 (COVID-19). (June 2022)

• Record Type: Journal Article
• Authors: Lozada, Ma. Cecilia; Medina, Henry; Sucaldito, Ma Sergia Fatima; Santos, Lourdes Ella; David-Ona, Deborah Ignacia; Oliva, Raymond
• Is Part Of: Journal of hypertension. Volume 40(2022)Supplement 1
• Page Start: e182
• Publication Date: 2022-06
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000837260.19491.33
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: RAAS inhibitors were speculated to increase expression of ACE2 receptors in the respiratory tract which was feared to lead to poorer outcomes among hypertensive patients infected with COVID-19. Current evidence has not confirmed Renin-Angiotensin-Aldosterone System inhibitors exposure as harmful in patients with COVID-19 infection. This study aims to determine the association between use of RAAS inhibitors and in-patient outcomes of adult hypertensive patients admitted for COVID-19. Design and method: A cross-sectional analytical study using case records was done on adult hypertensive patients admitted for COVID19 starting from March 2020 to March 2021 in a tertiary government hospital. The association of RAAS inhibitor use and in-patient outcomes was determined using Fisher's chi-square test. Results: A total of 2, 264 charts were reviewed for all COVID 19 patients admitted from March 2020 to March 2021, and 671 patients were determined to be hypertensive. Majority of hypertensive COVID-19 patients were male (52%), elderly (58%) and with moderate disease severity (51%). The most common comorbidities were community acquired pneumonia (59%), type 2 diabetes mellitus (44%) and chronic kidney disease (22%). A total of 66% (n = 442) of the hypertensive patients admitted for COVID were on RAAS inhibitors with losartan (40%) as the most commonly used agent. RAAS inhibitor use was not found to be associated with mortality (OR 0.74, 95% CI 0.57–1.10) and development of acute kidney injury (OR 1.12, 95% CI 1.12–1.69) among hypertensive COVID19 patients. However, RAAS inhibitor use was associated with decreased mortality among hypertensive patients classified with COVID-19 moderate disease (OR 0.42, 0.19–0.92, p-value 0.02). Conclusions: RAAS inhibitor use was not associated with increased mortality and development of acute kidney injury.