Association of outpatient use of renin-angiotensin-aldosterone system blockers on outcomes of acute respiratory illness during the COVID-19 pandemic: a cohort study.
Association of outpatient use of renin-angiotensin-aldosterone system blockers on outcomes of acute respiratory illness during the COVID-19 pandemic: a cohort study.
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DOI：
10.1136/bmjopen-2021-060305
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发表时间：
2022-07-06
期刊：
影响因子：
2.9
通讯作者：
Cummins, Nathan W.
中科院分区：
文献类型：
--
作者：
Jeffery, Molly Moore;e Silva, Lucas Oliveira J.;Bellolio, Fernanda;Garovic, Vesna D.;Dempsey, Timothy M.;Limper, Andrew;Cummins, Nathan W.
评估服用ACE抑制剂和血管紧张素受体阻滞剂（ARB）的患者与COVID-19所致急性病毒性呼吸道疾病（AVRI）后的临床结局之间的相关性。回顾性队列。美国; 2017-2018流感季节，2018-2019流感季节和2019-2020流感/COVID-19季节。患有高血压（HTN）的人服用ACEi，ARB或其他HTN药物，并经历AVRI。入院率、重症监护室（ICU）或冠心病监护室（CCU）、急性呼吸窘迫（ARD）、ARD综合征（ARDS）和全因死亡率的变化，比较COVID-19与前COVID-19流感季节。该队列包括1 059 474例AVRI发作（653 797例使用ACEi或ARB，405 677例使用其他HTN药物）。58.6%为女性，72.9%年龄≥65岁。ACEi/ARB队列在COVID-19流感季节的风险增加幅度大于其他HTN药物队列，五分之四的结局，住院风险增加1.5个百分点（pp）（95% CI 1.2 - 1.9 pp）和ICU/CCU使用（95% CI 0.3 - 2.7 pp）以及ARD风险额外增加0.7 pp（0.1 - 1.2 pp）和ARDS风险额外增加0.9 pp（0.4 - 1.3 pp）。死亡的绝对风险无统计学显著差异（-0.2 pp，95% CI-0.4至0.1 pp）。然而，ACEi/ARB组2019/2020年与2017/2018年的相对死亡风险（1.40（1.36 - 1.44））大于其他HTN药物队列（1.24（1.21 - 1.28））。在COVID-19大流行期间，使用ACEi/ARB治疗HTN的AVRI患者的不良结局增加幅度大于使用其他药物治疗HTN的患者。差异的绝对幅度较小，可能不支持临床实践的变化。
Evaluate the associations between patients taking ACE inhibitors and angiotensin receptor blockers (ARBs) and their clinical outcomes after an acute viral respiratory illness (AVRI) due to COVID-19. Retrospective cohort. The USA; 2017–2018 influenza season, 2018–2019 influenza season, and 2019–2020 influenza/COVID-19 season. People with hypertension (HTN) taking an ACEi, ARB or other HTN medications, and experiencing AVRI. Change in hospital admission, intensive care unit (ICU) or coronary care unit (CCU), acute respiratory distress (ARD), ARD syndrome (ARDS) and all-cause mortality, comparing COVID-19 to pre-COVID-19 influenza seasons. The cohort included 1 059 474 episodes of AVRI (653 797 filled an ACEi or ARB, and 405 677 other HTN medications). 58.6% were women and 72.9% with age ≥65. The ACEi/ARB cohort saw a larger increase in risk in the COVID-19 influenza season than the other HTN medication cohort for four out of five outcomes, with an additional 1.5 percentage point (pp) increase in risk of an inpatient stay (95% CI 1.2 to 1.9 pp) and of ICU/CCU use (95% CI 0.3 to 2.7 pp) as well as a 0.7 pp (0.1 to 1.2 pp) additional increase in risk of ARD and 0.9 pp (0.4 to 1.3 pp) additional increase in risk of ARDS. There was no statistically significant difference in the absolute risk of death (−0.2 pp, 95% CI −0.4 to 0.1 pp). However, the relative risk of death in 2019/2020 versus 2017/2018 for the ACEi/ARB group was larger (1.40 (1.36 to 1.44)) than for the other HTN medication cohort (1.24 (1.21 to 1.28)). People with AVRI using ACEi/ARBs for HTN had a greater increase in poor outcomes during the COVID-19 pandemic than those using other medications to treat HTN. The small absolute magnitude of the differences likely does not support changes in clinical practice.
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影响因子：
11.5
作者：
Rizk JG;Wenziger C;Tran D;Hashemi L;Moradi H;Streja E;Ahluwalia A
通讯作者：
Ahluwalia A
影响因子：
4.6
作者：
Soler MJ;Ribera A;Marsal JR;Mendez AB;Andres M;Azancot MA;Oristrell G;Méndez-Boo L;Cohen J;Barrabés JA;Ferreira-González I;Vall d’Hebron COVID-19 Working Group
通讯作者：
Vall d’Hebron COVID-19 Working Group
DOI：
10.1016/s2213-2600(20)30558-0
发表时间：
2021-03
期刊：
The Lancet. Respiratory medicine
影响因子：
--
作者：
Cohen JB;Hanff TC;William P;Sweitzer N;Rosado-Santander NR;Medina C;Rodriguez-Mori JE;Renna N;Chang TI;Corrales-Medina V;Andrade-Villanueva JF;Barbagelata A;Cristodulo-Cortez R;Díaz-Cucho OA;Spaak J;Alfonso CE;Valdivia-Vega R;Villavicencio-Carranza M;Ayala-García RJ;Castro-Callirgos CA;González-Hernández LA;Bernales-Salas EF;Coacalla-Guerra JC;Salinas-Herrera CD;Nicolosi L;Basconcel M;Byrd JB;Sharkoski T;Bendezú-Huasasquiche LE;Chittams J;Edmonston DL;Vasquez CR;Chirinos JA
通讯作者：
Chirinos JA
影响因子：
33.9
作者：
Killerby, Marie E.;Link-Gelles, Ruth;Tate, Jacqueline E.
通讯作者：
Tate, Jacqueline E.
影响因子：
2.6
作者：
Kurdi A;Abutheraa N;Akil L;Godman B
通讯作者：
Godman B