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Article data
Mehra (2020)
Cardiovascular Disease, Drug Therapy, and Mortality in Covid-19
https://doi.org/10.1056/NEJMoa2007621
https://www.nejm.org/doi/full/10.1056/NEJMoa2007621

Results
Treatment
Concomitant medication (Treated with ACEi vs. Not received)
COVID-19 (death)
Odds ratio: 0.330 (0.200-0.540) Adjusted model

Study characteristics

Asia, Europe, and North America

Prospective observational study

Registry

8910

Study population included 8910 hospitalized patients from 169 hospitals who had Covid-19, who were admitted between December 20, 2019, and March 15, 2020, and who completed their hospital course (discharged alive or died) by March 28, 2020.

The mean (±SD) age was 49±16 years (16.5% of the patients were >65 years of age), 40.0% of the patients were women, 63.5% were white, 7.9% were black, 6.3% were Hispanic, and 19.3% were Asian. We analyzed deidentified data from the Surgical Outcomes Collaborative (Surgisphere), an international registry. Our analysis included data from 169 hospitals located in 11 countries in Asia, Europe, and North America.

Total

3 Month


Results

COVID-19 (death)

515

Evaluated the relationship of cardiovascular disease and drug therapy with in-hospital death among hospitalized patients with Covid-19 who were admitted between December 20, 2019, and March 15, 2020, and were recorded in the Surgical Outcomes Collaborative registry as having either died in the hospital or survived to discharge as of March 28, 2020.

Treatment

Concomitant medication

ACE inhibitors ((angiotensin converting enzyme inhibitors) ) (2.1% vs. 6.1%; odds ratio, 0.33; 95% CI, 0.20 to 0.54)

Not received

Treated with ACEi

Odds ratio

0.330 (0.200-0.540)

Yes

No

Yes

age, race, coexisting conditions (coronary artery disease, congestive heart failure, cardiac arrhythmia, diabetes mellitus, COPD, current smoking, former smoking, hypertension, immunocompromised state, and hyperlipidemia), hospital location (according to country), and medications (ACE inhibitors, ARBs, beta-blockers, antiplatelet agents, statins, insulin, and oral hypoglycemic agents)


Other information

Cardiovascular disease is associated with an increased risk of in-hospital death among patients hospitalized with Covid-19. Our results did not confirm previous concerns regarding a potential harmful association of ACE inhibitors or ARBs with in-hospital death in this clinical context.

Good

Yes

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