Comparison of infection risks and clinical outcomes in patients with and without SARS-CoV-2 lung infection under renin-angiotensin-aldosterone system blockade: Systematic review and meta-analysis.
Comparison of infection risks and clinical outcomes in patients with and without SARS-CoV-2 lung infection under renin-angiotensin-aldosterone system blockade: Systematic review and meta-analysis.
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比较有和无SARS-CoV-2肺部感染的患者在肾素-血管紧张素-醛固酮系统阻断下的感染风险和临床结局：系统回顾和荟萃分析
DOI：
10.1111/bcp.14660
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发表时间：
2021-06
影响因子：
3.4
通讯作者：
Hocher B
中科院分区：
文献类型：
--
作者：
Chu C;Zeng S;Hasan AA;Hocher CF;Krämer BK;Hocher B
血管紧张素转换酶- 2 （ACE2）是SARS - CoV - 2的受体。动物研究表明，肾素-血管紧张素-醛固酮系统（RAAS）阻滞剂可能增加ACE2的表达，并可能增加SARS - CoV - 2感染的风险。ACE抑制剂（ACEI）治疗对非COVID - 19患者肺炎发病率的影响（25项研究，330780例患者）与肺炎风险降低26%相关（优势比[OR]: 0.74, P < .001）。在接受ACEI治疗的非COVID - 19患者中，肺炎相关死亡病例减少了27% （OR: 0.73, P = 0.004）。然而，血管紧张素II受体阻滞剂（ARB）治疗（10项研究，275621例非COVID - 19患者）并未改变患者的肺炎风险。在ARB治疗的非COVID - 19患者中，肺炎相关死亡病例仅在1项研究中进行了分析，并且显著降低（OR, 0.47； 95%可信区间，0.30至0.72）。来自11项研究（840万患者）的结果显示，ACEI治疗患者感染SARS - CoV - 2病毒的风险降低了13% (OR: 0.87, P = 0.014)，而来自10项研究（840万患者）的分析显示，arb治疗没有影响（OR, 0.92, P = 0.354）。来自67 644例COVID - 19患者的34项研究结果显示，RAAS阻断可使全因死亡率降低24% （OR = 0.76, P = 0.04）。acei降低了感染SARS - CoV - 2病毒的风险。阻断RAAS可降低COVID - 19患者的全因死亡率。acei还可降低非COVID - 19肺炎的风险。ACEI降低了非COVID - 19肺炎的全因死亡率，arb也可能降低了死亡率。
Angiotensin‐converting enzyme‐2 (ACE2) is the receptor for SARS‐CoV‐2. Animal studies suggest that renin–angiotensin–aldosterone system (RAAS) blockers might increase the expression of ACE2 and potentially increase the risk of SARS‐CoV‐2 infection. The effect of ACE inhibitor (ACEI) treatment on the pneumonia incidence in non‐COVID‐19 patients (25 studies, 330 780 patients) was associated with a 26% reduction of pneumonia risk (odds ratio [OR]: 0.74, P < .001). Pneumonia‐related death cases in ACEI‐treated non‐COVID‐19 patients were reduced by 27% (OR: 0.73, P = .004). However, angiotensin II receptor blockers (ARB) treatment (10 studies, 275 621 non‐COVID‐19 patients) did not alter pneumonia risk in patients. Pneumonia‐related death cases in ARB‐treated non‐COVID‐19 patients was analysed only in 1 study and was significantly reduced (OR, 0.47; 95% confidence interval, 0.30 to 0.72). Results from 11 studies (8.4 million patients) showed that the risk of getting infected with the SARS‐CoV‐2 virus was reduced by 13% (OR: 0.87, P = .014) in patients treated with ACEI, whereas analysis from 10 studies (8.4 million patients) treated with ARBs showed no effect (OR, 0.92, P = .354). Results from 34 studies in 67 644 COVID‐19 patients showed that RAAS blockade reduces all‐cause mortality by 24% (OR = 0.76, P = .04). ACEIs reduce the risk of getting infected with the SARS‐CoV‐2 virus. Blocking the RAAS may decrease all‐cause mortality in COVID‐19 patients. ACEIs also reduce the risk of non‐COVID pneumonia. All‐cause mortality due to non‐COVID pneumonia is reduced by ACEI and potentially by ARBs.
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作者：
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DOI：
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影响因子：
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DOI：
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发表时间：
2020-06-01
影响因子：
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