Please use this identifier to cite or link to this item: http://repositorio.ufla.br/jspui/handle/1/42196
metadata.artigo.dc.title: Estimation of Renin-Angiotensin-Aldosterone-System (RAAS)-Inhibitor effect on COVID-19 outcome: a meta-analysis
metadata.artigo.dc.creator: Pirola, Carlos J.
Sookoian, Silvia
metadata.artigo.dc.subject: COVID-19
Hypertension
Diabetes
Cardiovascular disease
Prognosis
Renin-Angiotensin-Aldosterone-System (RAAS) inhibitors
Angiotensin II-converting enzyme inhibitors
Angiotensin II receptor type 1 blockers
metadata.artigo.dc.publisher: Elsevier
metadata.artigo.dc.date.issued: Aug-2020
metadata.artigo.dc.identifier.citation: PIROLA, C. J.; SOOKOIAN, S. Estimation of Renin-Angiotensin-Aldosterone-System (RAAS)-Inhibitor effect on COVID-19 outcome: a meta-analysis. Journal of Infection, [S.l.], v. 81, n. 2, p. 276-281, Aug. 2020.
metadata.artigo.dc.description.abstract: Background and rationale Some studies of hospitalized patients suggested that the risk of death and/or severe illness due to COVID-19 is not associated with the use of angiotensin-converting enzyme inhibitors (ACEIs) and/or angiotensin II receptor type 1 blockers (ARBs). Nevertheless, some controversy still exists and there is limited information of the ACEIs/ARBs effect size on COVID-19 prognosis. Aim and Methods We aimed to measure the effect of ACEIs and/or ARBs on COVID-19 severe clinical illness by a meta-analysis. Literature search included all studies published since the COVID-19 outbreak began (December 2019) until May 9, 2020. We analyzed information from studies that included tested COVID-19 patients with arterial hypertension as comorbidity prior to hospital admission and history of taking ACEIs, ARBs, or ACEIs/ARBs. Results We included 16 studies that involved 24,676 COVID-19 patients, and we compared patients with critical (n = 4134) vs. non-critical (n = 20,542) outcomes. The overall assessment by estimating random effects shows that the use of ACEIs/ARBs is not associated with higher risk of in-hospital-death and/or severe illness among hypertensive patients with COVID-19 infection. On the contrary, effect estimate shows an overall protective effect of RAAS inhibitors/blockers (ACEIs, ARBs, and/or ACEIs/ARBs) with ∼ 23 % reduced risk of death and/or critical disease (OR: 0.768, 95%CI: 0.651-0.907, p=0.0018). The use of ACEIs (OR:0.652, 95%CI:0.478-0.891, p=0.0072) but not ACEIs/ARBs (OR:0.867, 95%CI:0.638-1.179, p =NS) or ARBs alone (OR:0.810, 95%CI:0.629-1.044, p=NS) may explain the overall protection displayed by RAAS intervention combined. Conclusion RAAS inhibitors might be associated with better COVID-19 prognosis.
metadata.artigo.dc.identifier.uri: https://www.sciencedirect.com/science/article/pii/S0163445320303297
http://repositorio.ufla.br/jspui/handle/1/42196
metadata.artigo.dc.language: en_US
Appears in Collections:FCS - Artigos sobre Coronavirus Disease 2019 (COVID-19)

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