Renin–angiotensin–aldosterone system inhibitors and the risk of mortality in patients with hypertension hospitalised for COVID-19: systematic review and meta-analysis

ObjectiveThe association between the use of renin–angiotensin–aldosterone (RAAS) inhibitors and the risk of mortality from COVID-19 is unclear. We aimed to estimate the association of RAAS inhibitors, including ACE inhibitors (ACEi) and angiotensin II receptor blockers (ARBs) with COVID-19 mortality...

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Bibliographic Details
Published in:Open heart 2020-11, Vol.7 (2), p.e001353
Main Authors: Ssentongo, Anna E, Ssentongo, Paddy, Heilbrunn, Emily S, Lekoubou, Alain, Du, Ping, Liao, Duanping, Oh, John S, Chinchilli, Vernon M
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Angiotensin Receptor Antagonists - therapeutic use
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Antihypertensive Agents - therapeutic use
Coronavirus Infections - diagnosis
Coronavirus Infections - mortality
Coronavirus Infections - therapy
COVID-19
Female
Hospitalization
Humans
Hypertension - diagnosis
Hypertension - drug therapy
Hypertension - mortality
Male
Meta-Analysis
Middle Aged
Pandemics
Pneumonia, Viral - diagnosis
Pneumonia, Viral - mortality
Pneumonia, Viral - therapy
Protective Factors
Renin-Angiotensin System - drug effects
Risk Assessment
Risk Factors
Treatment Outcome
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Summary:ObjectiveThe association between the use of renin–angiotensin–aldosterone (RAAS) inhibitors and the risk of mortality from COVID-19 is unclear. We aimed to estimate the association of RAAS inhibitors, including ACE inhibitors (ACEi) and angiotensin II receptor blockers (ARBs) with COVID-19 mortality risk in patients with hypertension.MethodsPubMed (MEDLINE) SCOPUS, OVID, Cochrane Library databases and medrxiv.org were searched from 1 January 2020 to 1 September 2020. Studies reporting the association of RAAS inhibitors (ACEi or ARBs) and mortality in patients with hypertension, hospitalised for COVID-19 were extracted. Two reviewers independently extracted appropriate data of interest and assessed the risk of bias. All analyses were performed using random-effects models on log-transformed risk ratio (RR) estimates, and heterogeneity was quantified.ResultsFourteen studies were included in the systematic review (n=73,073 patients with COVID-19; mean age 61 years; 53% male). Overall, the between-study heterogeneity was high (I2=80%, p
ISSN:2053-3624
2053-3624
DOI:10.1136/openhrt-2020-001353