Renin-angiotensin system blocker and the COVID-19 aggravation in patients with hypertension, diabetes, renal failure, Cerebro-cardiovascular disease, or pulmonary disease: Report by the COVID-19 Registry Japan. Issue 4 (October 2022)

• Record Type: Journal Article
• Authors: Yoshihara, Fumiki; Ohtsu, Hiroshi; Nakai, Michikazu; Tsuzuki, Shinya; Hayakawa, Kayoko; Terada, Mari; Matsunaga, Nobuaki; Yasuda, Satoshi; Ogawa, Hisao; Ohmagari, Norio
• Is Part Of: Journal of cardiology. Volume 80:Issue 4(2022)
• Page Start: 292
• Page End: 297
• Publication Date: 2022-10
• Subjects: ACEi angiotensin-converting enzyme inhibitors -- ARB angiotensin II receptor blockers -- COVID-19 coronavirus disease 2019 -- COPD chronic obstructive pulmonary disease -- COVIREGI-JP COVID-19 Registry Japan -- SARS-CoV-2 severe acute respiratory syndrome coronavirus 2 -- ACE2 angiotensin-converting enzyme 2 -- ICU intensive care unit -- BMI body mass index; COVID-19 -- Disease outcome -- Associated factors; Cardiology -- Periodicals; 616.12
• DOI: 10.1016/j.jjcc.2022.04.001
• Languages: English
• ISSNs: 0914-5087

Abstract

Abstract: Background: The role of angiotensin-converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB) in the pandemic context of coronavirus disease 2019 (COVID-19) continues to be debated. Patients with hypertension, diabetes mellitus, chronic renal failure, cerebro-cardiovascular disease, or chronic obstructive pulmonary disease (COPD), who often use ACEi/ARB, may be at risk of severe COVID-19. However, there are no data available on the association of ACEi/ARB use with COVID-19 severity in this population. Methods: This study is an observational study of patients with a positive severe acute respiratory syndrome coronavirus 2 test and inpatient treatment at a healthcare facility, using the registry information of COVIREGI-JP. Our primary outcomes were in-hospital death, ventilator support, extracorporeal membrane oxygenation support, and intensive care unit admission. Out of the 6055 patients, 1921 patients with preexisting hypertension, diabetes mellitus, chronic renal failure, cerebro-cardiovascular disease, or COPD were enrolled. Results: Factors associated with an increased risk of the primary outcomes were aging, male sex, COPD, severe renal impairment, and diabetes mellitus. No correlations were observed with ACEi/ARB, cerebro-cardiovascular diseases, or hypertension. Associated factors in male patients were aging, renal impairment, hypertension, and diabetes. In female patients, factors associated with an increased risk were aging, ACEi/ARB, renal impairment, and diabetes, whereas hypertension was associated with a lower risk of the primary outcomes. Conclusions: Independent factors for the primary outcomes were aging, male sex, COPD, severe renal impairment, and diabetes, but not ACEi/ARB. Based on this registry data analysis, more detailed data collection and analysis is needed with the cooperation of multiple healthcare facilities. Graphical abstract: Unlabelled Image Highlights: Coronavirus disease 2019 patients with hypertension (HT), diabetes mellitus (DM), chronic kidney disease (CKD), cardiovascular disease, or chronic obstructive pulmonary disease (COPD) from COVIREGI-JP were evaluated. Outcomes consisted of in-hospital death, ventilator support, extracorporeal membrane oxygenation, and intensive care unit admission. Related factors for outcomes were aging, male, COPD, CKD, and DM, but not angiotensin-converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB). In male patients, related factors for outcomes were aging, CKD, HT, and DM. In female patients, increased risk factors were aging, ACEi/ARB, CKD, and DM.