Table 2.
Comparison of mortality and severe/critical illness between COVID-19 ACEI/ARB users and non-ACEI/ARB users
| Study | Mortality | Severe/critical illnessa | ||||
|---|---|---|---|---|---|---|
| ACEI/ARB users (n/N; %) | Non-ACEI/ARB users (n/N; %) | Adjusted estimate (95% CI) | ACEI/ARB users (n/N; %) | Non-ACEI/ARB users (n/N; %) | Adjusted estimate (95% CI) | |
| Amaouche et al.b [35] | N/A | N/A | OR = 1.10 (0.49–2.48) | N/A | N/A | OR = 1.12 (0.59–2.13) |
| Chen C et al. [36] | 12/355; 3.4 | 95/827; 11.5 | HR = 0.28 (0.15–0.52) | 6/355; 1.7 | 25/827; 3.0 | – |
| Chen M et al.b [37] | 3/11; 27.3 | 28/112; 25.0 | – | – | – | – |
| Chen Y et al. [38] | 4/32; 12.5 | 10/39; 25.6 | – | – | – | – |
| Feng Y et al. [39] | – | – | – | 4/33; 12.1 | 36/80; 45.0 | – |
| Feng Z et al.b [40] | – | – | – | 1/16; 6.3 | 16/49; 32.7 | OR = 0.41 (0.05–3.19) |
| Gao et al. [41] | 4/183; 2.2 |
Overall cohort: 52/2694; 1.9 Hypertensive cohort: 30/667; 4.5 |
– | 74/183; 40.4 |
Overall cohort: 670/2694; 24.9 Hypertensive cohort: 221/667; 33.1 |
– |
| Guo et al. [42] | 7/19; 36.8 | 43/168; 25.6 | – | – | – | – |
| Hu et al. [43] | 1/65; 1.5 | 0/84; 0 | – | 28/65; 43.1 | 33/84; 39.3 | – |
| Huang et al. [44] | 0/20; 0.0 | 3/30; 10.0 | – | 13/20; 65.0 | 24/30; 80.0 | – |
| Li J et al. [45] | 21/115; 18.3 | 56/247; 22.7 | – | 57/115; 49.6 | 116/247; 47.0 | – |
| Li X et al. [46] | – | – | – | 19/42; 45.2 | 250/506; 49.4 | – |
| Liu et al.b [47] | – | – | – | 7/22; 31.8 | 31/56; 55.4 | – |
| Meng et al. [48] | 0/17; 0.0 | 1/25; 4.0 | – | 4/17; 23.5 | 12/25; 48.0 | – |
| Peng et al. [49] | 4/22; 18.2 | 13/90; 14.4 | – | 3/22; 13.6 | 13/90; 14.4 | – |
| Tan et al. [50] | 0/31; 0 | 11/69; 15.9 | – | 0/31; 0 | 9/69; 13.0 | – |
| Xu et al. [51] | 11/40; 27.5 | 21/61; 34.4 | – | 8/40; 20.0 | 17/61; 27.9 | – |
| Yan et al.b [52] | – | – | – | N/A | N/A |
ACEI: OR = 1.23 (0.19–7.93) ARB: OR = 0.77 (0.36–1.63) |
| Yang et al. [53] | 2/43; 4.7 |
Overall cohort: 19/208; 9.1 Hypertensive cohort: 11/83; 13.3 |
– | 15/43; 34.9 |
Overall cohort: 33/208; 15.9 Hypertensive cohort: 19/83; 22.9 |
– |
| Yuan et al. [54] | 6/130; 4.6 | 22/130; 16.9 | HR = 0.23 (0.09–0.56) | – | – | – |
| Zeng et al.b [55] | 2/28; 7.1 |
Overall cohort: 19/246; 7.7 Hypertensive cohort: 5/47; 10.6 |
– | 15/28; 53.6 |
Overall cohort: 102/246; 41.5 Hypertensive cohort: 15/47; 31.9 |
– |
| Zhang et al. [56] | 7/188; 3.7 | 92/940; 9.8 |
HR = 0.37 (0.15–0.89) |
6/188; 3.2 | 75/940; 8.0 | HR = 0.32 (0.13–0.80) |
| Zhou F et al. [57] | N/A | N/A |
Overall cohort (ACEI/ARB): HR = 0.39 (0.26–0.58) Hypertensive cohort (ACEI/ARB): HR = 0.32 (0.15–0.66) ACEI: HR = 0.49 (0.20–1.20) ARB: HR = 0.31 (0.18–0.53) |
– | – | – |
| Zhou X et al. [58] | 2/15; 13.3 | 5/21; 23.8 | – | – | – | – |
| Fosbøl et al. [59] | 181/895; 20.2 | 297/3585; 8.3 |
ACEI/ARB: HR = 0.83 (0.67–1.03) ACEI: HR = 0.98 (0.71–1.35) ARB: HR = 0.80 (0.60–1.09) |
203/895; 22.7 | 373/3585; 10.4 |
ACEI/ARB: HR = 1.15 (0.95–1.41) ACEI: HR = 1.21 (0.91–1.60) ARB: HR = 1.01 (0.78–1.31) |
| Dauchet et al.b [60] | – | – | – | 34/62; 54.8 | 54/125; 43.2 | – |
| Liabeuf et al. [61] | 17/96; 17.7 | 30/172; 17.4 | – | 35/96; 36.5 | 34/172; 19.8 | OR = 2.28 (1.17–4.42) |
| Oussalah et al. [62] | 10/43; 23.3 | 9/104; 8.7 | – | 20/43; 46.5 | 34/103; 33.0 | – |
| Zhou J et al.b [63] | – | – | – | 14/184; 7.6 | 4/792; 0.5 | OR = 1.10 (0.24–2.14) |
| Cannata et al. [64] | 7/56; 12.5 | 39/224; 17.4 | OR = 0.05 (0.01–0.54) | – | – | – |
| Conversano et al. [65] |
Overall cohort: 21/69; 30.4 Hypertensive cohort: 21/68; 30.9 |
Overall cohort: 21/122; 17.2 Hypertensive cohort: 13/28; 46.4 |
– | – | – | – |
| Felice et al. [66] | 15/82; 18.3 | 18/51; 35.3 | OR = 0.56 (0.17–0.83) | 21/82; 25.6 | 25/51; 49.0 | OR = 0.25 (0.09–0.66) |
| Ferrante et al. [67] | N/A | N/A | HR = 0.68 (0.41–1.14) | – | – | – |
| Giacomelli et al. [68] | 14/31; 45.2 | 34/202; 16.8 | – | – | – | – |
| Grasselli et al. [69] | N/A | N/A |
ACEI: HR = 0.97 (0.69–1.34) ARB: HR = 1.05 (0.85–1.29) |
– | – | – |
| Rossi et al. [70] | N/A | N/A |
ACEI: HR = 1.17 (0.97–1.42) ARB: HR = 1.16 (0.83–1.64) |
– | – | – |
| Sardu et al. [71] | 7/45; 15.6 | 2/17; 11.8 | – | 9/45; 20.0 | 3/17; 17.6 | – |
| Tedeschi et al. [72] | N/A | N/A | HR = 0.97 (0.68–1.39) | – | – | – |
| Ayed et al. [73] | 5/10; 50.0 | 10/93; 10.8 | – | – | – | – |
| Dalan et al. [74] | N/A | N/A |
ACEI: HR = 0.50 (0.08–3.24) ARB: HR = 2.87 (0.41–20.00) |
N/A | N/A |
ACEI: HR = 0.26 (0.10–0.68) ARB: HR = 2.19 (1.08–4.43) |
| Choi et al. [75] | 42/625; 6.7 | 69/625; 11.0 | OR = 0.48 (0.29–0.79) | 34/625; 5.4 | 55/625; 8.8 | OR = 0.49 (0.30–0.79) |
| Jung S et al. [76] | 33/377; 8.8 | 51/1577; 3.2 | OR = 0.88 (0.53–1.44) | – | – | – |
| Lee et al.b [77] | 50/977; 5.1 | 62/7289; 0.85 | HR = 1.07 (0.68–1.65) | – | – | – |
| Son et al. [78] | 30/77; 39.0 | 8/25; 32.0 |
ACEI/ARB: OR = 1.36 (0.51–3.66) ACEI: OR = 0.26 (0.03–2.26) ARB: OR = 2.10 (0.83–5.34) |
18/51; 35.3 | 4/15; 26.7 |
ACEI/ARB: OR = 1.52 (0.40–5.70) ACEI: OR = 2.24 (0.13–37.88) ARB: OR = 1.70 (0.46–6.32) |
| Amat-Santos et al. [79] | 2/5; 40.0 | 2/6; 33.3 | – | – | – | – |
| López-Otero et al. [80] | 11/210; 5.2 | 27/755; 3.6 |
ACEI/ARB: OR = 0.62 (0.17–2.26) ACEI: OR = 0.14 (0.01–1.57) ARB: OR = 1.54 (0.42–5.59) |
13/78; 16.7 | 20/156; 12.8 |
ACEI/ARB: OR = 0.87 (0.30–2.50) ACEI: OR = 0.97 (0.22–4.16) ARB: OR = 0.84 (0.25–2.87) |
| Selçuk et al. [81] | 31/74; 41.9 | 4/39; 10.3 | OR = 3.66 (1.11–18.18) | – | – | – |
| Baker et al.b [82] | 17/78; 21.8 | 63/233; 27.0 | – | – | – | – |
| Argenziano et al. [83] | – | – | – | 71/284; 25.0 | 165/716; 23.0 | – |
| Chang et al. [84] | – | – | – | 6/27; 22.2 | 50/150; 33.3 |
ACEI: OR = 0.62 (0.14–2.20) ARB: OR = 0.50 (0.11–1.80) |
| Chaudhri et al. [85] | 14/80; 17.5 | 25/220; 11.4 | – | 22/80; 27.5 | 59/220; 26.8 | – |
| Imam et al. [86] | N/A | N/A | OR = 1.20 (0.86–1.68) | – | – | – |
| Ip et al.b [87] | 137/460; 29.8 | 262/669; 39.2 | – | – | – | – |
| Khera et al. [88] | 664/4587; 14.5 | 466/3346; 13.9 |
ACEI: OR = 0.97 (0.81–1.16) ARB: OR = 1.15 (0.95–1.38) |
– | – | – |
| Lam et al. [89] | 10/164; 6.1 | 48/171; 28.1 | OR = 0.22 (0.10–0.46) | 20/164; 12.2 | 45/171; 26.3 | OR = 0.35 (0.19–0.64) |
| Mehta et al. [90] | 8/211; 3.8 | 34/1494; 2.3 | – | 22/212; 10.4 | 15/1523; 0.98 |
ACEI/ARB: OR = 1.64 (1.07–2.51) ACEI: OR = 1.77 (1.07–2.92) ARB: OR = 1.16 (0.67–2.02) |
| Richardson et al. [91] | 130/413; 31.5 | 254/953; 26.7 | – | 87/413; 21.1 | 141/953; 14.8 | – |
| Shah et al. [92] | 38/207; 18.4 | 48/324; 14.8 |
Overall cohort: OR = 0.82 (0.45–1.50) Hypertensive cohort: OR = 0.79 (0.43–1.44) |
59/207; 28.5 | 62/324; 19.1 |
Overall cohort: OR = 1.26 (0.74–2.15) Hypertensive cohort: OR = 1.25 (0.72–2.16) |
| Jung C et al. [93] | 62/157; 39.5 | 85/167; 50.9 |
ACEI: OR = 0.32 (0.15–0.67) |
– | – | – |
ACEI angiotensin-converting enzyme inhibitor, ARB angiotensin receptor blocker, CI confidence interval, COVID-19 coronavirus disease 2019, HR hazard ratio, N/A not available, OR odds ratio
aThe definition of severe/critical disease in the studies by Amaouche et al. [35], Feng et al. [39], Feng et al. [40], Gao et al. [41], Hu et al. [43], Huang et al. [44], Li et al. [45], Li et al. [46], Liu et al. [47], Meng et al. [48], Peng et al. [49], Yan et al. [52], and Yang et al. [53] is based on the definition given in ‘Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia’ by Chinese National Health Commission; Chen et al. [36] is based on the development of multiple organ dysfunction syndrome; Tan et al. [50] is based on the development of acute respiratory distress syndrome; Xu et al. [51], Fosbøl et al. [59], Dauchet et al. [60], Liabeuf et al. [61], Zhou et al. [63], Felice et al. [66], Sardu et al. [71], Dalan et al. [74], Son et al. [78], López-Otero et al. [80], Argenziano et al. [83], Chaudhri et al. [85], Lam et al. [89], Mehta et al. [90], Richardson et al. [91], and Shah et al. [92] are based on the requirement for admission into intensive care units; Zeng et al. [55] is based on the guideline for community-acquired pneumonia; Zhang et al. [56] is based on the development of septic shock; Oussalah et al. [62] is based on the requirement for intubation or mechanical ventilation; Choi et al. [75] is based on the requirement for mechanical ventilation, admission into intensive care units, continuous renal replacement therapy, or extracorporeal membrane oxygenation; and Chang et al. [84] is based on the requirement for admission into intensive care units or intubation
bPreprint