Angiotensin‐Converting Enzyme Inhibitors Or Angiotensin Ii Receptor Blockers And Prognosis Of Hypertensive Patients Hospitalized With Covid‐19

Covino, Marcello; De Matteis, Giuseppe; Burzo, Maria Livia; Santoro, Michele; Fuorlo, Mariella; Sabia, Luca; Sandroni, Claudio; Gasbarrini, Antonio; Franceschi, Francesco; Gambassi, Giovanni

BACKGROUND: Among hypertensive patients, the association between treatment with angiotensin‐converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) and the clinical severity of Covid‐19, remains uncertain. AIMS: To determine whether hypertensive patients hospitalized with Covid‐19 are at risk of worse outcomes if on treatment with ACEIs or ARBs compared to other anti‐hypertensive medications. METHODS: This is a retrospective study conducted at a single academic medical center [Fondazione Policlinico A.Gemelli IRCCS, Rome, Italy] from March 1(st) to 31 (st), 2020. We compared patients on treatment with an ACEIs/ARBs (ACEIs/ARBs group) to patients receiving other anti‐hypertensive medications (No‐ACEIs/ARBs group). The endpoints of the study were the all‐cause in‐hospital death and the combination of in‐hospital death or need for ICU admission. RESULTS: The sample included 166 Covid‐19 patients; median age was 74 years and 109 were men (66%). Overall, 111 patients (67%) were taking an ACEIs or ARBs. Twenty‐nine patients (17%) died during hospital stay, and 51 (31%) met the combined endpoint. After adjustment for comorbidities, age and degree of severity at the presentation, ACEIs or ARBs treatment was an independent predictor neither of in‐hospital death nor of the combination of in‐hospital death/need for ICU. No differences were documented between treatment with ACEIs compared to ARBs. CONCLUSIONS: Among hypertensive patients hospitalized for Covid‐19, treatment with ACEIs or ARBs is not associated with an increased risk of in‐hospital death. This article is protected by copyright. All rights reserved.