%0 Journal Article
%A Roy-Vallejo, Emilia
%A Sanchez-Purificacion, Aquilino
%A Torres-Peña, Jose David
%A Sanchez-Moreno, Beatriz
%A Arnalich, Francisco
%A Garcia-Blanco, Maria Jose
%A Lopez-Miranda, Jose
%A Romero-Cabrera, Juan Luis
%A Herrero Gil, Carmen Rosario
%A Bascunana, Jose
%A Rubio-Rivas, Manuel
%A Pintos-Otero, Sara
%A Martinez-Sempere, Veronica
%A Ballano-Rodriguez-Solis, Jesus
%A Gil-Sanchez, Ricardo
%A Luque-Del-Pino, Jairo
%A Gonzalez-Noya, Amara
%A Navas-Alcantara, Maria Sierra
%A Cortes-Rodriguez, Begoña
%A Alcala, Jose Nicolas
%A Suarez-Lombraña, Ana
%A Andres-Soler, Jorge
%A Gomez-Huelgas, Ricardo
%A Casas-Rojo, Jose Manuel
%A Millan-Nuñez-Cortes, Jesus
%T Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers Withdrawal Is Associated with Higher Mortality in Hospitalized Patients with COVID-19.
%D 2021
%@ 2077-0383
%U http://hdl.handle.net/10668/18098
%X Our main aim was to describe the effect on the severity of ACEI (angiotensin-converting enzyme inhibitor) and ARB (angiotensin II receptor blocker) during COVID-19 hospitalization. A retrospective, observational, multicenter study evaluating hospitalized patients with COVID-19 treated with ACEI/ARB. The primary endpoint was the incidence of the composite outcome of prognosis (IMV (invasive mechanical ventilation), NIMV (non-invasive mechanical ventilation), ICU admission (intensive care unit), and/or all-cause mortality). We evaluated both outcomes in patients whose treatment with ACEI/ARB was continued or withdrawn. Between February and June 2020, 11,205 patients were included, mean age 67 years (SD = 16.3) and 43.1% female; 2162 patients received ACEI/ARB treatment. ACEI/ARB treatment showed lower all-cause mortality (p < 0.0001). Hypertensive patients in the ACEI/ARB group had better results in IMV, ICU admission, and the composite outcome of prognosis (p < 0.0001 for all). No differences were found in the incidence of major adverse cardiovascular events. Patients previously treated with ACEI/ARB continuing treatment during hospitalization had a lower incidence of the composite outcome of prognosis than those whose treatment was withdrawn (RR 0.67, 95%CI 0.63–0.76). ARB was associated with better survival than ACEI (HR 0.77, 95%CI 0.62–0.96). ACEI/ARB treatment during COVID-19 hospitalization was associated with protection on mortality. The benefits were greater in hypertensive, those who continued treatment, and those taking ARB.
%K ACEI
%K ARB
%K COVID-19
%K MACE
%K prognosis
%~