Skip to main content
Oxford University Press - PMC COVID-19 Collection logoLink to Oxford University Press - PMC COVID-19 Collection
. 2020 Jun 8:hpaa096. doi: 10.1093/ajh/hpaa096

Use of RAAS inhibitors and risk of clinical deterioration in COVID-19: results from an Italian cohort of 133 hypertensives

C Felice 1,2, C Nardin 2, G L Di Tanna 3, U Grossi 4, E Bernardi 1, L Scaldaferri 1, M Romagnoli 5, L Tonon 2, P Cavasin 2, S Novello 4, R Scarpa 2, A Farnia 6, E De Menis 7, R Rigoli 8, F Cinetto 2, P Pauletto 9, C Agostini 2, M Rattazzi 2,
PMCID: PMC7314218  PMID: 32511678

Abstract

Background

The effect of chronic use of renin–angiotensin–aldosterone system (RAAS) inhibitors on the severity of COVID-19 infection is still unclear in patients with hypertension. We aimed to investigate the association between chronic use of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) and COVID-19 related outcomes in hypertensive patients.

Methods

A single center study was conducted on 133 consecutive hypertensive subjects presenting to the Emergency Department with acute respiratory symptoms and/or fever who were diagnosed with COVID-19 infection between 9th and 31st March 2020.

Results

All patients were grouped according to their chronic antihypertensive medications (ACEIs, N=40; ARBs, N=42; not on RAAS inhibitors, N=51). There was no statistical difference between ACEIs and ARBs groups in terms of hospital admission rate, oxygen therapy and need for non-invasive ventilation. Patients chronically treated with RAAS inhibitors showed a significantly lower rate of admission to semi-intensive/intensive care units, when compared to the non-RAAS population (odds ratio [OR] 0.25, CI95% 0.09-0.66 p=0.006). Similarly, the risk of mortality was lower in the former group, although not reaching statistical significance (OR 0.56, CI95% 0.17-1.83, p=0.341).

Conclusions

Our data suggest that chronic use of RAAS inhibitors does not negatively affect clinical course of COVID-19 in hypertensive patients. Further studies are needed to confirm this finding and determine whether RAAS inhibitors may have a protective effect on COVID 19-related morbidity and mortality.

Keywords: COVID-19 infection, SARS-COV-2, hypertensive patients, ACEIs/ARBs, mortality


Articles from American Journal of Hypertension are provided here courtesy of Oxford University Press

RESOURCES