Background:
The use of angiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB) in COVID-19 patients has been controversial given the role of the angiotensin-converting enzyme 2 receptor as a cellular infiltration point for the virus.
Methods:
Since March of 2020, data was obtained from adult patients with COVID-19 admitted to Rush University Systems for Health through automatic extraction from the electronic medical record. We looked for other factors that were associated with mortality. All variables in Figure 1 were included in a single multivariable logistic regression model with in-hospital mortality as the primary outcome.
Results:
Of the 3863 patients in the cohort, 1290 (33.4%) were on an ACEi/ARB during their admission. When adjusted for the other variables in Figure 1, in-hospital ACEi/ARB usage was associated with decreased risk of mortality (adjusted odds ratio [aOR] 0.52 [CI 0.38 - 0.73]; p < 0.001) compared to those not taking them. In the same model, oral anticoagulation (aOR 0.25 [CI 0.17 - 0.37]; p < 0.001) was also found to be protective against in-hospital mortality. Increased BMI, male sex, initial high respiratory rate, history of atrial fibrillation and valve disease increased the risk of in-hospital mortality.
Conclusion:
Consistent with previous findings certain factors increase mortality, but in-hospital use of ACEi/ARBs and anticoagulation were independently associated with decreased mortality during COVID-19 hospitalization.
Footnotes
Poster Contributions
For exact presentation time, refer to the online ACC.22 Program Planner at https://www.abstractsonline.com/pp8/#!/10461
Session Title: Spotlight on Special Topics Flatboard Poster Selections: COVID
Abstract Category: 61. Spotlight on Special Topics: Coronavirus Disease (COVID-19)