Outcomes Associated with the Use of Renin-Angiotensin-Aldosterone System Blockade in Hospitalized Patients with SARS-CoV-2 Infection.
Outcomes Associated with the Use of Renin-Angiotensin-Aldosterone System Blockade in Hospitalized Patients with SARS-CoV-2 Infection.
复制标题
与住院的SARS-COV-2感染患者使用肾素 - 血管紧张素 - 醛固酮系统阻断有关的结果。
DOI：
10.34067/kid.0003792020
复制
发表时间：
2020-08
期刊：
影响因子：
--
通讯作者：
Mallipattu SK
中科院分区：
文献类型：
--
作者：
Chaudhri I;Koraishy FM;Bolotova O;Yoo J;Marcos LA;Taub E;Sahib H;Bloom M;Ahmad S;Skopicki H;Mallipattu SK
在美国，对于因感染新冠病毒而住院的高血压患者，继续使用血管紧张素转换酶抑制剂（ACEIs）和血管紧张素II受体阻滞剂（ARBs）所带来的益处或危害，尤其是对炎症的影响，相关数据并不明确。
这是一项单中心队列研究，研究对象为2020年3月7日至4月1日期间在石溪大学医学中心连续住院的新冠患者，包括这两个日期在内。数据收集涵盖已知的合并症病史、用药情况、生命体征以及实验室检查值（入院时及住院期间）。研究结果包括炎症负荷（多种炎症标志物的综合评分）、急性肾损伤（AKI）、入住重症监护病房（ICU）情况、是否需要有创机械通气以及死亡率。
在研究队列的300名患者中，80名患者（26.7%）在入院前有使用ACEI或ARB的病史，其中61.3%（49/80）的患者在住院期间继续使用这些药物。多变量分析显示，入院前使用ACEI或ARB的病史与较差的预后并无关联。此外，住院期间继续使用这些药物与不良预后的增加无关，且预测入住ICU的人数会减少（优势比=0.25，0.08 - 0.81），同时炎症负荷的严重程度也会降低（C反应蛋白峰值（6.9±3.1mg/dl，p = 0.03）和炎症评分峰值（降低2.3±1.1单位，p = 0.04））。
入院前使用ACEI或ARB与新冠患者的不良预后无关，并且对于住院的新冠患者，继续使用ACEI或ARB的治疗益处不会被不良预后所抵消。
Data regarding the benefits or harm associated with the continuation of Angiotensin Converting Enzyme Inhibitors (ACEIs) and Angiotensin II Receptor Blockers (ARBs), especially the impact on inflammation, in hypertensive, hospitalized patients with COVID-19 in the United States is unclear. This is a single-center cohort study of sequentially hospitalized patients with COVID-19 at Stony Brook University Medical Center from March 7, 2020 to April 1, 2020, inclusive of these dates. Data collection included history of known comorbidities, medications, vital signs and laboratory values (admission and during the hospitalization). Outcomes include inflammatory burden (composite scores for multiple markers of inflammation), acute kidney injury (AKI), admission to the intensive care unit (ICU), need for invasive mechanical ventilation, and mortality. Of the 300 patients in the study cohort, 80 patients (26.7%) had history of ACEI or ARB use prior to admission, with 61.3% (49/80) of these patients continuing the medications during hospitalization. Multivariable analysis revealed that the history of ACEI or ARB use prior to hospitalization was not associated with worse outcomes. In addition, the continuation of these agents during hospitalization was not associated with an increase in adverse outcomes and predicted fewer ICU admissions (OR=0.25, 0.08–0.81) with a decrease in the severity of inflammatory burden (peak CRP (6.9±3.1mg/dl, p=0.03) and peak inflammation score (2.3±1.1unit reduction, p=0.04)). Use of ACEI or ARBs prior to hospitalization was not associated with adverse outcomes in COVID-19 and the therapeutic benefits of continuing ACEI or ARB in hospitalized patients with COVID-19 was not offset by adverse outcomes.
登录
查看更多内容
影响因子：
1.8
作者：
Kim, Joohae;Choi, Sun Mi;Lee, Sang-Min
通讯作者：
Lee, Sang-Min
DOI：
10.1016/j.dsx.2020.04.020
发表时间：
2020-07-01
影响因子：
10
作者：
Astuti, Indwiani;Ysrafil
通讯作者：
Ysrafil
影响因子：
15.9
作者：
Chen, Guang;Wu, Di;Ning, Qin
通讯作者：
Ning, Qin
影响因子：
158.5
作者：
Mancia, Giuseppe;Rea, Federico;Corrao, Giovanni
通讯作者：
Corrao, Giovanni
影响因子：
39.2
作者：
Levey AS;Stevens LA;Schmid CH;Zhang YL;Castro AF 3rd;Feldman HI;Kusek JW;Eggers P;Van Lente F;Greene T;Coresh J;CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration)
通讯作者：
CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration)