Relationship between angiotensin-converting enzyme inhibitors or angiotensin receptor blockers and COVID-19 incidence or severe disease

April 9, 2021

Tse, Garya; Zhou, Jiandongb; Lee, Sharenc; Wong, Wing Takd; Li, Xintaoe; Liu, Tonga; Cao, Zhidongf; Zeng, Daniel Dajunf; Wai, Abraham K.C.g; Wong, Ian Chi Keih; Cheung, Bernard Man Yungi; Zhang, Qingpengb

Journal of Hypertension

This paper studied the relationship between ACE inhibitors (ACEIs)/angiotensin receptor blockers (ARBs) and COVID-19 positivity and severe disease and found that the use of ACEIs and ARBs were significant predictors of COVID-19 positivity and severe disease outcomes. ACEIs and ARBs are commonly used to treat cardiovascular conditions and have been shown in previous studies to worsen COVID-19 disease outcomes and mortality. Some speculate that ACEIs and ARBs may have negative impacts on COVID-19 patients. The authors explored this by conducting a retrospective study on Hong Kong patients who underwent COVID-19 RT-PCR over seven months. Statistical analysis was used to determine how variables such as underlying conditions and medications, including ACEIs and ARBs, affected COVID-19 positivity rate and disease severity. ACEI and ARB use were higher among COVID-19 positive patients than controls. After correcting for confounding variables, the authors found a significant relationship between ACEI and ARB use and COVID-19 positivity and severe disease outcomes. This could be due to ACEIs and ARBs altering the expression of the SARS-CoV-2 entry receptor, ACE2. ACEIs and ARBs were found to have the same impact on positivity rates and disease severity. The results of this study vary from some other studies, which have found no clear relationship between ACEI/ARB use and COVID-19 positivity and severity.

Tse, Garya; Zhou, Jiandongb; Lee, Sharenc; Wong, Wing Takd; Li, Xintaoe; Liu, Tonga; Cao, Zhidongf; Zeng, Daniel Dajunf; Wai, Abraham K.C.g; Wong, Ian Chi Keih; Cheung, Bernard Man Yungi; Zhang, Qingpengb Relationship between angiotensin-converting enzyme inhibitors or angiotensin receptor blockers and COVID-19 incidence or severe disease, Journal of Hypertension: April 09, 2021 - Volume Publish Ahead of Print - Issue - doi: 10.1097/HJH.0000000000002866

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