Table 3.
Risk of COVID-19 requiring admission to hospital and current use of RAAS inhibitors compared with current use of other antihypertensive drugs, by severity of disease
| Cases (n=1139) | Matched controls (n=11 390) | Adjusted odds ratio* | ||
|---|---|---|---|---|
| Most severe cases | ||||
| n | 393 | 3930 | .. | |
| Sex | ||||
| Male | 264/393 (67·2%) | 2640/3930 (67·2%) | .. | |
| Female | 129/393 (32·8%) | 1290/3930 (32·8%) | .. | |
| Age, years | 75·3 (12·3) | 75·3 (12·3) | .. | |
| Current use | ||||
| Other antihypertensive drugs | 64/393 (16·3%) | 484/3930 (12·3%) | 1 (ref) | |
| RAAS inhibitors† | 215/393 (54·7%) | 1592/3930 (40·5%) | 1·08 (0·80–1·47) | |
| ACE inhibitors | 101/393 (25·7%) | 905/3930 (23·0%) | 0·92 (0·65–1·29) | |
| Angiotensin-receptor blockers | 105/393 (26·7%) | 655/3930 (16·7%) | 1·25 (0·89–1·77) | |
| Non-use | 114/393 (29·0%) | 1854/3930 (47·2%) | 0·48 (0·34–0·69) | |
| Less severe cases | ||||
| n | 746 | 7460 | .. | |
| Sex | ||||
| Male | 431/746 (57·8%) | 4310/7460 (57·8%) | .. | |
| Female | 315/746 (42·2%) | 3150/7460 (42·2%) | .. | |
| Age, years | 65·8 (15·9) | 65·8 (15·9) | .. | |
| Current use | ||||
| Other antihypertensive drugs | 91/746 (12·2%) | 645/7460 (8·7%) | 1 (ref) | |
| RAAS inhibitors† | 282/746 (37·8%) | 2230/7460 (29·9%) | 0·86 (0·66–1·11) | |
| ACE inhibitors | 139/746 (18·6%) | 1287/7460 (17·3%) | 0·74 (0·56–0·99) | |
| Angiotensin-receptor blockers | 132/746 (17·7%) | 897/7460 (12·0%) | 0·99 (0·74–1·33) | |
| Non-use | 373/746 (50·0%) | 4585/7460 (61·5%) | 0·57 (0·43–0·75) | |
Data are n (%), mean (SD), and odds ratio with 95% CI in parentheses. Most severe cases are those who died and those admitted to an intensive care unit. Less severe cases are all other inpatients. The different pharmacological classes examined are mutually exclusive categories, so that patients who used combinations are counted only once, applying the following criteria: ACE inhibitors include current users of any ACE inhibitors alone or combined with any other antihypertensive drug (in fixed-dose combinations or in different medicinal products); angiotensin-receptor blockers include current users of any angiotensin-receptor blocker, alone or combined with any other antihypertensive drug that is not an ACE inhibitor (in fixed-dose combinations or in different medicinal products); and other antihypertensive drugs include calcium-channel blockers, diuretics, β-blockers, and α-blockers, alone or combined (excluding RAAS inhibitors; either in fixed-dose combinations or in different medicinal products). ACE=angiotensin-converting enzyme. RAAS=renin–angiotensin–aldosterone system.
Adjusted for the matching variables plus history of diabetes, dyslipidaemia, ischaemic heart disease, heart failure, atrial fibrillation, thromboembolic disease, cerebrovascular accident, chronic obstructive pulmonary disease, asthma, cancer, and chronic renal failure.
Including ACE inhibitors, angiotensin-receptor blockers, aldosterone antagonists, and renin inhibitors.