Mortality from angiotensin-converting enzyme-inhibitors and angiotensin receptor blockers in people infected with COVID-19: a cohort study of 3.7 million people.
Mortality from angiotensin-converting enzyme-inhibitors and angiotensin receptor blockers in people infected with COVID-19: a cohort study of 3.7 million people.
复制标题
DOI：
10.1093/fampra/cmac094
复制
发表时间：
2023-03-28
期刊：
影响因子：
2.2
通讯作者：
中科院分区：
文献类型：
--
作者：
人们担心血管紧张素转换酶抑制剂（ACE-I）和血管紧张素受体阻滞剂（ARBs）可能促进严重急性呼吸综合征冠状病毒2的传播，导致更严重的冠状病毒病（COVID-19）和死亡风险增加。我们的目的是调查在大流行的前6个月，ACE-I/ARB治疗与COVID-19患者死亡风险之间的关系。我们使用牛津-皇家全科医生学院（RCGP）研究和监测中心（RSC）初级保健数据库的计算机医疗记录，确定了一组被确诊或可能诊断为COVID-19的成年人（2020年1月1日至6月21日）。这包括英国英格兰的465个全科诊所，全国有代表性的人口为370万。我们构建了混合效应logistic回归模型，量化ACE-I/ARBs与COVID-19患者全因死亡率之间的关系，并对社会人口统计学因素、合并症、并发用药、吸烟状况、执业聚类和家庭人数进行了调整。在2020年1月1日至2020年6月21日的研究期间，样本中有9586例COVID-19病例，1463例（15.3%）死亡。在校正分析中，ACE-I和arb与全因死亡率无关（校正优势比[OR] 1.02, 95%可信区间[CI] 0.85-1.21和OR 0.84, 95% CI 0.67-1.07）。使用ACE-I/ARB这两种常用药物并没有改变被诊断为COVID-19的人的全因死亡率。我们的研究结果应该为患者和开处方者在大流行期间继续使用这些药物的决定提供信息。
Concerns have been raised that angiotensin-converting enzyme-inhibitors (ACE-I) and angiotensin receptor blockers (ARBs) might facilitate transmission of severe acute respiratory syndrome coronavirus 2 leading to more severe coronavirus disease (COVID-19) disease and an increased risk of mortality. We aimed to investigate the association between ACE-I/ARB treatment and risk of death amongst people with COVID-19 in the first 6 months of the pandemic. We identified a cohort of adults diagnosed with either confirmed or probable COVID-19 (from 1 January to 21 June 2020) using computerized medical records from the Oxford-Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) primary care database. This comprised 465 general practices in England, United Kingdom with a nationally representative population of 3.7 million people. We constructed mixed-effects logistic regression models to quantify the association between ACE-I/ARBs and all-cause mortality among people with COVID-19, adjusted for sociodemographic factors, comorbidities, concurrent medication, smoking status, practice clustering, and household number. There were 9,586 COVID-19 cases in the sample and 1,463 (15.3%) died during the study period between 1 January 2020 and 21 June 2020. In adjusted analysis ACE-I and ARBs were not associated with all-cause mortality (adjusted odds ratio [OR] 1.02, 95% confidence interval [CI] 0.85–1.21 and OR 0.84, 95% CI 0.67–1.07, respectively). Use of ACE-I/ARB, which are commonly used drugs, did not alter the odds of all-cause mortality amongst people diagnosed with COVID-19. Our findings should inform patient and prescriber decisions concerning continued use of these medications during the pandemic.
登录
查看更多内容
DOI：
10.3399/bjgp20x713393
发表时间：
2020-12
期刊：
The British journal of general practice : the journal of the Royal College of General Practitioners
影响因子：
--
作者：
Joy M;Hobbs FR;Bernal JL;Sherlock J;Amirthalingam G;McGagh D;Akinyemi O;Byford R;Dabrera G;Dorward J;Ellis J;Ferreira F;Jones N;Oke J;Okusi C;Nicholson BD;Ramsay M;Sheppard JP;Sinnathamby M;Zambon M;Howsam G;Williams J;de Lusignan S
通讯作者：
de Lusignan S
影响因子：
8.5
作者：
de Lusignan S;McGee C;Webb R;Joy M;Byford R;Yonova I;Hriskova M;Matos Ferreira F;Elliot AJ;Smith G;Rafi I
通讯作者：
Rafi I
影响因子：
8.5
作者：
de Lusignan S;Liyanage H;McGagh D;Jani BD;Bauwens J;Byford R;Evans D;Fahey T;Greenhalgh T;Jones N;Mair FS;Okusi C;Parimalanathan V;Pell JP;Sherlock J;Tamburis O;Tripathy M;Ferreira F;Williams J;Hobbs FDR
通讯作者：
Hobbs FDR
DOI：
10.1152/ajplung.00498.2016
发表时间：
2018-01-01
影响因子：
4.9
作者：
Sodhi, Chhinder P.;Wohlford-Lenane, Christine;Jia, Hongpeng
通讯作者：
Jia, Hongpeng
影响因子：
4.5
作者：
de Lusignan, Simon;Sherlock, Julian;Joy, Mark
通讯作者：
Joy, Mark