TABLE 4.
Subgroup meta‐analyses pooled estimates with 95%CI of the effects of ACEIs/ARBs on COVID‐19 related clinical outcomes
| Death (n = 15) | |||
|---|---|---|---|
| ACEIs/ARBs | ACEIs | ARBs | |
| Adjusted outcome measure | |||
| Adjusted OR | 0.973 (0.260, 1.660) | NA | NA |
| Crude OR | 1.048 (0.772, 1.424) | 1.049 (0.751, 1.464)* | 1.181 (0.983, 1.418)* |
| Number of studies | 2 vs 9 | 0 vs 2 | 0 vs 2 |
| Peer‐reviewed article? | |||
| Yes | 0.894 (0.522, 1.533) | NA | NA |
| No | 1.004 (0.716, 1.408) | 1.049 (0.751, 1.464)* | 1.181 (0.983, 1.418)* |
| Number of studies | 6 vs 5 | 0 vs 2 | 0 vs 2 |
| Study's quality | |||
| Good quality | 1.113 (0.884, 1.400) | NA | NA |
| Poor quality | 0.915 (0.627, 1.336) | 1.049 (0.751,1.464)* | 1.181 (0.983,1.418)* |
| Number of studies | 2 vs 9 | 0 vs 2 | 0 vs 2 |
| Study's country | |||
| Europe | 1.176 (0.932, 1.483) | 1.523 (0.728, 3.185) | 1.645 (0.838, 3.229) |
| USA | 0.92 (0.494, 1.714) | 0.97 (0.811, 1.161) | 1.15 (0.954, 1.386) |
| Asia | 0.753 (0.401, 1.413) | NA | NA |
| Number of studies | 3 vs 2 vs 6 | 1 vs 1 vs 0 | 1 vs 1 vs 0 |
| ICU admission (n = 12) | |||
|---|---|---|---|
| Adjusted outcome measure | |||
| Adjusted OR | NA | NA | NA |
| Crude OR | 1.086 (0.652, 1.809)* | 0.945 (0.650, 1.376)* | 1.490 (1.126, 1.973)* |
| Number of studies | 0 vs 6 | 0 vs 3 | 0 vs 3 |
| Peer‐reviewed article? | |||
| Yes | 1.560 (1.234, 1.972) | NA | NA |
| No | 0.762 (0.295, 1.972) | 0.945 (0.650, 1.376)* | 1.490 (1.126, 1.973)* |
| Number of studies | 3 vs 3 | 0 vs 3 | 0 vs 3 |
| Study's quality | |||
| Good quality | 0.364 (0.224, 0.591) | NA | NA |
| Poor quality | 1.445 (0.133, 1.843) | 0.945 (0.650, 1.376)* | 1.490 (1.126, 1.973)* |
| Number of studies | 1 vs 5 | 0 vs 3 | 0 vs 3 |
| Study's country | |||
| Europe | 0.495 (0.253, 0.966) | 0.945 (0.650, 1.376)* | 1.490 (1.126, 1.973)* |
| USA | 1.591 (1.277, 1.983) | NA | NA |
| Asia | 1.439 (0.600, 3.453) | NA | NA |
| Number of studies | 2 vs 3. vs 1 | 3 vs 0. vs 0 | 3 vs 0. vs 0 |
| Death/ICU admission (n = 7) | |||
|---|---|---|---|
| Adjusted outcome measure | |||
| Adjusted OR | 0.630 (0.471, 0.842) | NA | NA |
| Crude OR | 0.783 (0.493, 1.243) | 0.888 (0.694, 1.136)* | 0.830 (0.650, 1.061)* |
| Number of studies | 1 vs 2 | 0 vs 2 | 0 vs 2 |
| Peer‐reviewed article? | |||
| Yes | NA | 0.910 (0.690, 1.210) | 0.830 (0.630, 1.100) |
| No | 0.670 (0.524, 0.857)* | 0.820 (0.490, 1.360) | 0.830 (0.500, 1.400) |
| Number of studies | 0 vs 3 | 1 vs 1 | 1 vs 1 |
| Study's quality | |||
| Good quality | 0.630 (0.471, 0.842) | 0.910 (0.687, 1.205) | 0.830 (0.628, 1.097) |
| Poor quality | 0.783 (0.493, 1.243) | 0.820 (0.492, 1.366) | 0.830 (0.496, 1.389) |
| Number of studies | 1 vs 2 | 1 vs 1 | 1 vs 1 |
| Study's country | |||
| Europe | 0.679 (0.520, 0.887) | 0.888 (0.694, 1.136) | 0.830 (0.650, 1.061) |
| USA | NA | NA | NA |
| Asia | 0.599 (0.251, 1.430) | NA | NA |
| Number of studies | 2 vs 0 vs 1 | 2 vs 0 vs 0 | 2 vs 0 vs 0 |
| Risk of COVID‐19 infection (n = 12) | |||
|---|---|---|---|
| Adjusted outcome measure | |||
| Adjusted OR | 1.190 (0.962, 1.473) | 1.180 (0.867, 1.605) | 1.290 (0.930, 1.790) |
| Crude OR | 0.986 (0.904, 1.077) | 1.015 (0.620, 1.662) | 0.240 (0.170, 0.340) |
| Number of studies | 1 vs 6 | 1 vs 2 | 1 vs 1 |
| Peer‐reviewed article? | |||
| Yes | 1.030 (0.941, 1.128) | 1.180 (0.867, 1.605) | 1.290 (0.930, 1.790) |
| No | 0.948 (0.790, 1.138) | 1.015 (0.620, 1.662) | 0.240 (0.170, 0.340) |
| Number of studies | 4 vs 3 | 1 vs 2 | 1 vs 1 |
| Study's quality | |||
| Good quality | NA | 0.650 (0.265, 1.597) | 0.240 (0.170, 0.339) |
| Poor quality | 1.014 (0.935, 1.099)* | 1.176 (0.933, 1.481) | 1.290 (0.930, 1.790) |
| Number of studies | 0 vs 7 | 1 vs 2 | 1 vs 1 |
| Study's country | |||
| Europe | 0.956 (0.695, 1.316) | 1.170 (0.825, 1.660) | NA |
| USA | 0.99 (0.901, 1.087) | NA | NA |
| Asia | 1.131 (0.942, 1.358) | 1.023 (0.622, 1.684) | 0.557 (0.107, 2.895)* |
| Number of studies | 1 vs 3 vs 3 | 1 vs 0 vs 2 | 0 vs 0 vs 2 |
| Severe COVID‐19 (n = 12) | |||
|---|---|---|---|
| Adjusted outcome measure | |||
| Adjusted OR | 0.480 (0.108, 2.130) | NA | NA |
| Crude OR | 0.795 (0.525, 1.206) | 0.718 (0.264, 1.955)* | 0.506 (0.247, 1.036)* |
| Number of studies | 1 vs 5 | 0 vs 3 | 0 vs 3 |
| Peer‐reviewed article? | |||
| Yes | 0.895 (0.614, 1.303) | 0.595 (0.067, 5.296) | 0.333 (0.069, 1.607) |
| No | 0.387 (0.144, 1.040) | 0.755 (0.245, 2.328) | 0.509 (0.176, 1.474) |
| Number of studies | 4 vs 2 | 1 vs 2 | 1 vs 2 |
| Study's quality | |||
| Good quality | NA | 1.230 (0.190, 7.946) | 0.770 (0.362, 1.638) |
| Poor quality | 0.782 (0.529, 1.154)* | 0.578 (0.176, 1.893) | 0.283 (0.101, 0.792) |
| Number of studies | 0 vs 6 | 1 vs 2 | 1 vs 2 |
| Study's country | |||
| Europe | 0.480 (0.108, 1.130) | NA | NA |
| USA | 0.994 (0.820, 1.205) | NA | NA |
| Asia | 0.513 (0.216, 1.216) | 0.718 (0.264, 1.955)* | 0.506 (0.247, 1.036)* |
| Number of studies | 1 vs 1 vs 4 | 0 vs 0 vs 3 | 0 vs 0 vs 3 |
| Severe pneumonia (n = 2) | |||
|---|---|---|---|
| Adjusted outcome measure | |||
| Adjusted OR | 0.410 (0.050, 3.275) | NA | NA |
| Crude OR | 2.462 (0.939, 6.452) | NA | NA |
| Number of studies | 1 vs 1 | ||
| Peer‐reviewed article? | |||
| Yes | NA | NA | NA |
| No | 1.285 (0.237, 6.958) | NA | NA |
| Number of studies | 0 vs 2 | ||
| Study's quality | |||
| Good quality | NA | NA | NA |
| Poor quality | 1.285 (0.237, 6.958) | NA | NA |
| Number of studies | 0 vs 2 | ||
| Study's country | |||
| Europe | NA | NA | NA |
| USA | NA | NA | NA |
| Asia | 1.285 (0.237, 6.958) | ||
| Number of studies | 0 vs 0 vs 2 | ||
| Hospitalization (n = 15) | |||
|---|---|---|---|
| Adjusted outcome measure | |||
| Adjusted OR | 1.300 (1.113, 1.518) | 1.170 (0.900, 1.520) | 1.0 (0.702, 1.424) |
| Crude OR | 1.032 (0.561, 1.897) | 1.056 (0.684, 1.631) | 0.865 (0.674, 1.109) |
| Number of studies | 1 vs 4 | 1 vs 4 | 1 vs 4 |
| Peer‐reviewed article? | |||
| Yes | 1.930 (1.377, 2.705) | NA | NA |
| No | 0.977 (0.647, 1.474) | 1.077 (0.791, 1.465)* | 0.907 (0.740, 1.112)* |
| Number of studies | 1 vs 4 | 0 vs 5 | 0 vs 5 |
| Study's quality | |||
| Good quality | 1.300 (1.113, 1.518) | NA | NA |
| Poor quality | 1.032 (0.561, 1.897) | 1.077 (0.791, 1.465)* | 0.907 (0.740, 1.112)* |
| Number of studies | 1 vs 4 | 0 vs 5 | 0 vs 5 |
| Study's country | |||
| Europe | 0.907 (0.413, 1.992) | 1.181 (0.843, 1.656) | 0.922 (0.721, 1.179) |
| USA | 1.589 (1.033, 2.443) | 0.77 (0.527, 1.124) | 0.877 (0.611, 1.258) |
| Asia | 0.569 (0.178, 1.815) | NA | NA |
| Number of studies | 2 vs 2 vs 1 | 4 vs 1 vs 0 | 4 vs 1 vs 0 |
| Hospital discharge (n = 3) | |||
|---|---|---|---|
| Adjusted outcome measure | |||
| Adjusted OR | NA | NA | NA |
| Crude OR | 1.213 (0.739, 1.991) | NA | NA |
| Number of studies | 0 vs 3 | ||
| Peer‐reviewed article? | |||
| Yes | 0.844 (0.663, 1.074) | NA | NA |
| No | 1.513 (1.184, 1.935) | NA | NA |
| Number of studies | 1 vs 2 | ||
| Study's quality | |||
| Good quality | NA | NA | NA |
| Poor quality | 1.213 (0.739, 1.991) | NA | NA |
| Number of studies | 0 vs 3 | ||
| Study's country | |||
| Europe | NA | NA | NA |
| USA | 1.122 (0.641, 1.964) | NA | NA |
| Asia | 1.862 (0.659, 5.26) | NA | NA |
| Number of studies | 0 vs 2 vs 1 | ||
| Ventilator use (n = 8) | |||
|---|---|---|---|
| Adjusted outcome measure | |||
| Adjusted OR | NA | NA | NA |
| Crude OR | 1.492 (0.804, 2.770) | 1.014 (0.03, 34.758) | 0.985 (0.084, 11.57) |
| Number of studies | 0 vs 4 | 0 vs 2 | 0 vs 2 |
| Peer‐reviewed article? | |||
| Yes | 1.141 (0.606, 2.150) | 0.078 (0.001, 6.878) | 0.251 (0.053, 1.185) |
| No | 3.338 (2.035, 5.475) | 3.603 (1.889, 6.872) | 3.129 (1.699, 5.761) |
| Number of studies | 1 vs 3 | 1 vs 1 | 1 vs 1 |
| Study's quality | |||
| Good quality | NA | NA | NA |
| Poor quality | 1.492 (0.804, 2.770) | 1.014 (0.030, 34.758) | 0.985 (0.084, 11.570) |
| Number of studies | 0 vs 4 | 0 vs 2 | 0 vs 2 |
| Study's country | |||
| Europe | 3.338 (2.035, 5.475) | 3.603 (1.889, 6.872) | 3.129 (1.699, 5.762) |
| USA | 1.524 (1.171, 1.985) | NA | NA |
| Asia | 0.202 (0.043, 0.947) | 0.078 (0.001, 6.469) | 0.251 (0.053, 1.187) |
| Number of studies | 1 vs 2 vs 1 | 1 vs 0 vs 1 | 1 vs 0 vs 1 |
*
Indicates that the pooled estimate is the same as the overall analyses because all the studies were in one group; NA: not applicable indicating that no studies were available to perform meta‐analyses for these outcomes;