View Risk


Article data
Bean (2020)
Treatment with ACE-inhibitors is associated with less severe disease with SARS-Covid-19 infection in a multi-site UK acute Hospital Trust
https://doi.org/10.1101/2020.04.07.20056788
https://www.medrxiv.org/content/10.1101/2020.04.07.20056788v1

Results
Comorbidities
Hypertension (Present vs. Not present)
COVID-19 (severe/fatal)
Odds ratio: 2.200 (1.000-4.900) Adjusted model

Study characteristics

United Kingdom

Retrospective observational study

Medical records

205

An early cohort of 205 acute inpatients with COVID-19 at King’s College Hospital and Princess Royal University Hospital, London, UK

205 confirmed positive symptomatic inpatients aged 63+20 (SD) years and 52% males. Baseline characteristics are 51·2% with hypertension, 30·2% with diabetes and 14·6% with ischaemic heart disease or heart failure. Of the 205 patients, 53 patients died or required critical care support within 7 days of symptoms and 152 patients did not. The inclusion criteria of only patients needing admission is likely why this critical outcome figure is relatively high (25·9%) compared to fatality rate in population studies but is comparable to hospital case series.17 14% (5/37) patients with exposure to an ACE-inhibitor died or required critical care support compared to 29% (48/168) for patients without such exposure.

Total

7 Day


Results

COVID-19 (severe/fatal)

53

Death or admission to a critical care unit for organ-support within 7 days of symptoms onset (symptoms defined as fever, cough, dyspnoea, myalgia, chest pain or delirium). Patients were stratified according to drug exposure to ACEi or ARB within 7 days before symptoms or during inpatient treatment (prior to an endpoint being reached).

Comorbidities

Hypertension

Early data from China during the SARS-Cov2 pandemic suggest that patients with hypertension or diabetes have an increased risk of severe COVID-19 disease. hypertension, 30·2% with ischaemic heart dis

Not present

Present

Odds ratio

2.200 (1.000-4.900)

No

No

Yes

ACEi, hypertension, Age and gender (Model 2)


Other information

Based on these early results and the absence of any evidence suggesting harm,patients on treatment with ACE-inhibitors should continue these drugs during their COVID-19 illness as per current guidelines. Active research is merited on whether ACE inhibition or enhancement of ACE2 may have a therapeutic role in severe COVID-19 disease.

Good

Yes

Go Back