Comparative analysis between the use of renin-angiotensin system antagonists and clinical outcomes of hospitalized patients with COVID-19 respiratory infection
Comparative analysis between the use of renin-angiotensin system antagonists and clinical outcomes of hospitalized patients with COVID-19 respiratory infection
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DOI：
10.1016/j.medcli.2020.07.004
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发表时间：
2020-12-11
期刊：
影响因子：
3.9
通讯作者：
Rodriguez-Martinez, Marta
中科院分区：
文献类型：
--
作者：
Martinez-del Rio, Jorge;Piqueras-Flores, Jesus;Rodriguez-Martinez, Marta
简介：高血压与COVID-19感染患者的预后较差相关，因此人们担心肾素-血管紧张素系统（RAS）抑制剂可能会影响这些患者的预后。方法：这是一项观察性研究，从3月1日至4月30日，921名连续的COVID-19呼吸道感染患者在真实的城市综合大学医院住院，2020.收集患者的人口学资料、病史、临床特征、实验室检查资料、住院期间的治疗干预措施和临床结局。结果：本组患者平均年龄78岁，59.2%的患者有高血压病史。既往接受过RAS抑制剂治疗的患者（42.4%）显示主要复合终点（死亡率或需要有创机械通气）的风险较低。RAS抑制剂治疗（门诊治疗和住院期间）对死亡率和有创通气的需求均无影响。两组之间的时间-事件分析无差异。结论：COVID-19呼吸道感染患者入院前接受RAS抑制剂治疗与主要复合终点的风险降低相关，即使在住院期间处方了这些药物，也未显示对死亡率或有创机械通气需求的影响。(c)2020 Elsevier Espana，S.L.U. All rights reserved.
Introduction: Hypertension has been associated with worse outcomes in patients with COVID-19 infection, so concerns have been raised about the possibility that inhibitors of the renin-angiotensin system (RAS) could influence the prognosis of these patients.Methods: This is an observational study of 921 consecutive patients admitted with COVID-19 respiratory infection to Hospital General Universitario Ciudad Real from March 1 to April 30, 2020. Following data were collected including patient demographic information, medical history, clinical characteristics, laboratory data, therapeutic interventions during the hospitalization and clinical outcomes.Results: The mean age was 78 years, and 59.2% of patients had a history of hypertension. Patients with previous treatment with RAS inhibitor (42.4%) showed lower risk of the primary composite endpoint (mortality or need for invasive mechanical ventilation). Treatment with RAS inhibitor (both outpatient treatment and during hospitalization) had neither effect on mortality nor need for invasive ventilation. There were no differences in time-to-event analysis between groups.Conclusions: RAS inhibitor treatment prior to admission in patients with COVID-19 respiratory infection was associated with lower risk of the primary composite endpoint and did not show neither impact on mortality nor need for invasive mechanical ventilation, even if these drugs were prescribed during hospitalization. (c) 2020 Elsevier Espana, S.L.U. All rights reserved.