Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Comparison of Renin–Angiotensin–Aldosterone System Inhibitors with Other Antihypertensives in Association with Coronavirus Disease-19 Clinical Outcomes: Systematic Review and Meta-Analysis

Version 1 : Received: 21 May 2020 / Approved: 24 May 2020 / Online: 24 May 2020 (17:48:42 CEST)

How to cite: Bezabih, Y.M.; Bezabih, A.; Admassie, E.; Peterson, G.M.; Bezabhe, W. Comparison of Renin–Angiotensin–Aldosterone System Inhibitors with Other Antihypertensives in Association with Coronavirus Disease-19 Clinical Outcomes: Systematic Review and Meta-Analysis. Preprints 2020, 2020050392 (doi: 10.20944/preprints202005.0392.v1). Bezabih, Y.M.; Bezabih, A.; Admassie, E.; Peterson, G.M.; Bezabhe, W. Comparison of Renin–Angiotensin–Aldosterone System Inhibitors with Other Antihypertensives in Association with Coronavirus Disease-19 Clinical Outcomes: Systematic Review and Meta-Analysis. Preprints 2020, 2020050392 (doi: 10.20944/preprints202005.0392.v1).

Abstract

Since the effects of renin–angiotensin–aldosterone system (RAAS) inhibitors on the clinical outcomes of coronavirus disease-19 (COVID-19) have been conflicting in different studies, we performed this meta-analysis. A systematic search of published articles was performed in PubMed and EMBASE from January-May 5, 2020. Studies that reported the clinical outcomes of patients with COVID-19, stratified by the class of concomitant antihypertensive drug therapy, were included. The Mantel-Haenszel random effects model was used to estimate pooled odds ratio (OR). A total of 6,997 hypertensive patients with COVID-19 were included. The overall risk of poor patient outcomes (severe COVID-19 or death) was lower in patients taking RAAS inhibitors (OR=0.84, 95% CI: [0.73, 0.96]; P=0.017) compared with those receiving non-RAAS inhibitor antihypertensives. Patients taking angiotensin-I-converting enzyme inhibitors (ACEIs) were less likely to experience poor clinical outcomes (OR=0.73, 95% CI: [0.58-0.92]; P=0.01) compared with those receiving angiotensin-II receptor blockers (ARBs). Compared to all other antihypertensives, ACEIs decreases the risk poor COVID-19 outcomes (OR=0.77, 95% CI: [0.63-0.93]) while ARBs did not (OR=1.13, 95% CI: [0.95-1.35]). The risk of poor patient outcomes from COVID-19 was lower in patients who received RAAS inhibitors compared with those who took non-RAAS inhibitors. Unlike ARBs, ACEIs might help in decreasing the severity and mortality of COVID-19.

Subject Areas

RAAS inhibitors; COVID-19; coronavirus; angiotensin; clinical outcome; antihypertensive

Comments (0)

We encourage comments and feedback from a broad range of readers. See criteria for comments and our diversity statement.

Leave a public comment
Send a private comment to the author(s)
Views 0
Downloads 0
Comments 0
Metrics 0


×
Alerts
Notify me about updates to this article or when a peer-reviewed version is published.
We use cookies on our website to ensure you get the best experience.
Read more about our cookies here.