{"title":"新冠肺炎合并高血压住院患者应用血管紧张素转换酶抑制剂、血管紧张素II受体阻滞剂或其他降压药:435例患者回顾性分析","authors":"Seyma Baslilar, Bengu Saylan","doi":"10.5144/0256-4947.2021.268","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The angiotensin-converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARBs) are widely used for the treatment of hypertension (HT). Whether the use of these drugs increases the infectivity of novel coronavirus and results in an additional risk for morbidity and mortality of COVID-19 is a matter of interest.</p><p><strong>Objectives: </strong>Assess the effect of ACEI/ARBs compared with other hypertensives on the clinical course and outcome in COVID-19 pneumonia.</p><p><strong>Design: </strong>Retrospective.</p><p><strong>Settings: </strong>Tertiary care hospital.</p><p><strong>Patients and methods: </strong>We collected data on adult inpatients with COVID-19 pneumonia using ACEI/ARBs versus other antihypertensives between 15 March 2020, and 15 February 2021.</p><p><strong>Main outcome measures: </strong>Severity, clinical course, mortality, and time to PCR negativity between patients using ACEI/ARBs and other antihypertensives.</p><p><strong>Sample size: </strong>435 RESULTS: ACEI/ARBs were used by 203 patients (46.6%) (median age: 71 [41-94] years), while 232 patients (53.4%) were using other antihypertensives (median age: 69 [22-93] years, <i>P</i>=.645 vs age of ACEI/ARB users). There were no statistically significant differences between the ACEI/ARBs users and non-users in the number of patients admitted to intensive care (65 cases [32%] vs. 74 cases [31.9%], <i>P</i>=.978), the median duration of stay in hospital (8 [1-54] days vs.7 [1-55] days, <i>P</i>=.806) the median duration of ICU stay (8 [1-40] days vs. 6 [1-25] days), and the mortality rate (48 cases [23.6%] vs. 61 [26.3%], <i>P</i>=.525). While the median days before transfer to the ICU was shorter in ACE/ARBI non-users (2 [1-15] days vs. 3 [1-21] days, <i>P</i>=.02), the difference was not important clinically. The median time to PCR negativity was similar in ACEI/ARBs users and non-users (13 [7-34] days for users and 13 [5-45] days for non-users), (<i>P</i>=.083).</p><p><strong>Conclusions: </strong>ACEI/ARB use is probably unrelated to poor prognosis in COVID-19 pneumonia inpatients. ACEI/ARBs did not prolong the time to PCR negativity. We conclude that using ACEI/ARBs probably does not increase the infectivity of SARS-CoV-2.</p><p><strong>Limitations: </strong>Pharmacological therapies were not discussed in detail. The use of corticosteroids may affect the time to PCR negativity. We could not analyze the effect of obesity because of a lack of data.</p><p><strong>Conflict of interest: </strong>None.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":"41 5","pages":"268-273"},"PeriodicalIF":1.5000,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ff/2a/0256-4947.2021.268.PMC8497007.pdf","citationCount":"0","resultStr":"{\"title\":\"Patients with hypertension hospitalized with COVID-19 pneumonia using angiotensinconverting enzyme inhibitors and angiotensin II receptor blockers or other antihypertensives: retrospective analysis of 435 patients.\",\"authors\":\"Seyma Baslilar, Bengu Saylan\",\"doi\":\"10.5144/0256-4947.2021.268\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The angiotensin-converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARBs) are widely used for the treatment of hypertension (HT). Whether the use of these drugs increases the infectivity of novel coronavirus and results in an additional risk for morbidity and mortality of COVID-19 is a matter of interest.</p><p><strong>Objectives: </strong>Assess the effect of ACEI/ARBs compared with other hypertensives on the clinical course and outcome in COVID-19 pneumonia.</p><p><strong>Design: </strong>Retrospective.</p><p><strong>Settings: </strong>Tertiary care hospital.</p><p><strong>Patients and methods: </strong>We collected data on adult inpatients with COVID-19 pneumonia using ACEI/ARBs versus other antihypertensives between 15 March 2020, and 15 February 2021.</p><p><strong>Main outcome measures: </strong>Severity, clinical course, mortality, and time to PCR negativity between patients using ACEI/ARBs and other antihypertensives.</p><p><strong>Sample size: </strong>435 RESULTS: ACEI/ARBs were used by 203 patients (46.6%) (median age: 71 [41-94] years), while 232 patients (53.4%) were using other antihypertensives (median age: 69 [22-93] years, <i>P</i>=.645 vs age of ACEI/ARB users). There were no statistically significant differences between the ACEI/ARBs users and non-users in the number of patients admitted to intensive care (65 cases [32%] vs. 74 cases [31.9%], <i>P</i>=.978), the median duration of stay in hospital (8 [1-54] days vs.7 [1-55] days, <i>P</i>=.806) the median duration of ICU stay (8 [1-40] days vs. 6 [1-25] days), and the mortality rate (48 cases [23.6%] vs. 61 [26.3%], <i>P</i>=.525). While the median days before transfer to the ICU was shorter in ACE/ARBI non-users (2 [1-15] days vs. 3 [1-21] days, <i>P</i>=.02), the difference was not important clinically. The median time to PCR negativity was similar in ACEI/ARBs users and non-users (13 [7-34] days for users and 13 [5-45] days for non-users), (<i>P</i>=.083).</p><p><strong>Conclusions: </strong>ACEI/ARB use is probably unrelated to poor prognosis in COVID-19 pneumonia inpatients. ACEI/ARBs did not prolong the time to PCR negativity. We conclude that using ACEI/ARBs probably does not increase the infectivity of SARS-CoV-2.</p><p><strong>Limitations: </strong>Pharmacological therapies were not discussed in detail. The use of corticosteroids may affect the time to PCR negativity. We could not analyze the effect of obesity because of a lack of data.</p><p><strong>Conflict of interest: </strong>None.</p>\",\"PeriodicalId\":8016,\"journal\":{\"name\":\"Annals of Saudi Medicine\",\"volume\":\"41 5\",\"pages\":\"268-273\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2021-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ff/2a/0256-4947.2021.268.PMC8497007.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Saudi Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.5144/0256-4947.2021.268\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2021/10/7 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Saudi Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5144/0256-4947.2021.268","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/10/7 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
背景:血管紧张素转换酶抑制剂(ACEI)和血管紧张素受体阻滞剂(ARBs)被广泛用于治疗高血压(HT)。这些药物的使用是否会增加新型冠状病毒的传染性，并导致COVID-19发病率和死亡率的额外风险，这是一个值得关注的问题。目的:比较ACEI/ARBs与其他高血压患者对COVID-19肺炎临床病程和转结局的影响。设计:回顾性。环境:三级保健医院。患者和方法:我们收集了2020年3月15日至2021年2月15日期间使用ACEI/ arb与其他抗高血压药物治疗的COVID-19肺炎成年住院患者的数据。主要结局指标:使用ACEI/ARBs和其他抗高血压药物的患者的严重程度、临床病程、死亡率和PCR阴性时间。结果:使用ACEI/ARBs的患者203例(46.6%)(中位年龄71[41-94]岁)，同时使用其他抗高血压药物的患者232例(53.4%)(中位年龄69[22-93]岁，P=。645 vs ACEI/ARB用户的年龄)。ACEI/ARBs使用者与非使用者在重症监护住院人数(65例[32%]对74例[31.9%]，P=.978)、中位住院时间(8[1-54]天对7[1-55]天，P=.806)、ICU中位住院时间(8[1-40]天对6[1-25]天)、死亡率(48例[23.6%]对61例[26.3%]，P=.525)方面差异无统计学意义。未使用ACE/ARBI的患者转至ICU前的中位时间较短(2[1-15]天vs. 3[1-21]天，P= 0.02)，但临床差异不显著。ACEI/ARBs使用者和非使用者到PCR阴性的中位时间相似(使用者为13[7-34]天，非使用者为13[5-45]天)，(P= 0.083)。结论:新型冠状病毒肺炎住院患者使用ACEI/ARB可能与预后不良无关。ACEI/ARBs不延长PCR阴性时间。我们的结论是，使用ACEI/ARBs可能不会增加SARS-CoV-2的传染性。局限性:没有详细讨论药物治疗。皮质类固醇的使用可能会影响到PCR阴性的时间。由于缺乏数据，我们无法分析肥胖的影响。利益冲突:无。
Patients with hypertension hospitalized with COVID-19 pneumonia using angiotensinconverting enzyme inhibitors and angiotensin II receptor blockers or other antihypertensives: retrospective analysis of 435 patients.
Background: The angiotensin-converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARBs) are widely used for the treatment of hypertension (HT). Whether the use of these drugs increases the infectivity of novel coronavirus and results in an additional risk for morbidity and mortality of COVID-19 is a matter of interest.
Objectives: Assess the effect of ACEI/ARBs compared with other hypertensives on the clinical course and outcome in COVID-19 pneumonia.
Design: Retrospective.
Settings: Tertiary care hospital.
Patients and methods: We collected data on adult inpatients with COVID-19 pneumonia using ACEI/ARBs versus other antihypertensives between 15 March 2020, and 15 February 2021.
Main outcome measures: Severity, clinical course, mortality, and time to PCR negativity between patients using ACEI/ARBs and other antihypertensives.
Sample size: 435 RESULTS: ACEI/ARBs were used by 203 patients (46.6%) (median age: 71 [41-94] years), while 232 patients (53.4%) were using other antihypertensives (median age: 69 [22-93] years, P=.645 vs age of ACEI/ARB users). There were no statistically significant differences between the ACEI/ARBs users and non-users in the number of patients admitted to intensive care (65 cases [32%] vs. 74 cases [31.9%], P=.978), the median duration of stay in hospital (8 [1-54] days vs.7 [1-55] days, P=.806) the median duration of ICU stay (8 [1-40] days vs. 6 [1-25] days), and the mortality rate (48 cases [23.6%] vs. 61 [26.3%], P=.525). While the median days before transfer to the ICU was shorter in ACE/ARBI non-users (2 [1-15] days vs. 3 [1-21] days, P=.02), the difference was not important clinically. The median time to PCR negativity was similar in ACEI/ARBs users and non-users (13 [7-34] days for users and 13 [5-45] days for non-users), (P=.083).
Conclusions: ACEI/ARB use is probably unrelated to poor prognosis in COVID-19 pneumonia inpatients. ACEI/ARBs did not prolong the time to PCR negativity. We conclude that using ACEI/ARBs probably does not increase the infectivity of SARS-CoV-2.
Limitations: Pharmacological therapies were not discussed in detail. The use of corticosteroids may affect the time to PCR negativity. We could not analyze the effect of obesity because of a lack of data.
期刊介绍：
The Annals of Saudi Medicine (ASM) is published bimonthly by King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. We publish scientific reports of clinical interest in English. All submissions are subject to peer review by the editorial board and by reviewers in appropriate specialties. The journal will consider for publication manuscripts from any part of the world, but particularly reports that would be of interest to readers in the Middle East or other parts of Asia and Africa. Please go to the Author Resource Center for additional information.
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