e03a2274cb91e7e3ea8ea36ac6d7f370 pmc_34204014.pdf b44e55bb364ee577c9fedc90f21bce5c7314e2a0 pmc_34204014.pdf 5ff178285125867fda621a22b9d655dd4fe37157d090f356743f447789cfbbee pmc_34204014.pdf Title: Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers Withdrawal Is Associated with Higher Mortality in Hospitalized Patients with COVID-19 Subject: Our main aim was to describe the effect on the severity of ACEI (angiotensin-converting enzyme inhibitor) and ARB (angiotensin II receptor blocker) during COVID-19 hospitalization. A retrospective, observational, multicenter study evaluating hospitalized patients with COVID-19 treated with ACEI/ARB. The primary endpoint was the incidence of the composite outcome of prognosis (IMV (invasive mechanical ventilation), NIMV (non-invasive mechanical ventilation), ICU admission (intensive care unit), and/or all-cause mortality). We evaluated both outcomes in patients whose treatment with ACEI/ARB was continued or withdrawn. Between February and June 2020, 11,205 patients were included, mean age 67 years (SD = 16.3) and 43.1% female; 2162 patients received ACEI/ARB treatment. ACEI/ARB treatment showed lower all-cause mortality (p < 0.0001). Hypertensive patients in the ACEI/ARB group had better results in IMV, ICU admission, and the composite outcome of prognosis (p < 0.0001 for all). No differences were found in the incidence of major adverse cardiovascular events. Patients previously treated with ACEI/ARB continuing treatment during hospitalization had a lower incidence of the composite outcome of prognosis than those whose treatment was withdrawn (RR 0.67, 95%CI 0.63–0.76). ARB was associated with better survival than ACEI (HR 0.77, 95%CI 0.62–0.96). ACEI/ARB treatment during COVID-19 hospitalization was associated with protection on mortality. The benefits were greater in hypertensive, those who continued treatment, and those taking ARB. Keywords: COVID-19; ACEI; ARB; prognosis; MACE Author: Emilia Roy-Vallejo, Aquilino Sánchez Purificación, José David Torres Peña, Beatriz Sánchez Moreno, Francisco Arnalich, María José García Blanco, José López Miranda, Juan Luis Romero-Cabrera, Carmen Rosario Herrero Gil, José Bascunana, Manuel Rubio-Rivas, Sara Pintos Otero, Verónica Martínez Sempere, Jesús Ballano Rodríguez-Solís, Ricardo Gil Sánchez, Jairo Luque del Pino, Amara González Noya, María Sierra Navas-Alcántara, Begoña Cortés Rodríguez, José Nicolás Alcalá, Ana Suárez-Lombraña, Jorge Andrés Soler, Ricardo Gómez-Huelgas, José Manuel Casas-Rojo and Jesús Millán Núñez-Cortés and on behalf of the SEMI-COVID-19 Network Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Fri Jun 18 03:48:53 2021 CEST ModDate: Fri Jun 18 04:05:00 2021 CEST Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 13 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 4065583 bytes 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edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1e7c7811 Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77ec78b9 Children: Item: Title: Study Population Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1a3869f4 Item: Title: Outcomes of Prognosis Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@a38d7a3 Item: Title: Major Adverse Cardiovascular Events Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77f99a05 Item: Title: ACEI/ARB Continuation Versus Withdrawal during Hospitalization Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@63440df3 Item: Title: Comparison between ACEI and ARB Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@3aeaafa6 Item: Title: Discussion Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@76a3e297 Item: Title: Conclusions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@4d3167f4 Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@ed9d034 Info: Title: Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers Withdrawal Is Associated with Higher Mortality in Hospitalized Patients with COVID-19 Author: Emilia Roy-Vallejo, Aquilino Sánchez Purificación, José David Torres Peña, Beatriz Sánchez Moreno, Francisco Arnalich, María José García Blanco, José López Miranda, Juan Luis Romero-Cabrera, Carmen Rosario Herrero Gil, José Bascunana, Manuel Rubio-Rivas, Sara Pintos Otero, Verónica Martínez Sempere, Jesús Ballano Rodríguez-Solís, Ricardo Gil Sánchez, Jairo Luque del Pino, Amara González Noya, María Sierra Navas-Alcántara, Begoña Cortés Rodríguez, José Nicolás Alcalá, Ana Suárez-Lombraña, Jorge Andrés Soler, Ricardo Gómez-Huelgas, José Manuel Casas-Rojo and Jesús Millán Núñez-Cortés and on behalf of the SEMI-COVID-19 Network Subject: Our main aim was to describe the effect on the severity of ACEI (angiotensin-converting enzyme inhibitor) and ARB (angiotensin II receptor blocker) during COVID-19 hospitalization. A retrospective, observational, multicenter study evaluating hospitalized patients with COVID-19 treated with ACEI/ARB. The primary endpoint was the incidence of the composite outcome of prognosis (IMV (invasive mechanical ventilation), NIMV (non-invasive mechanical ventilation), ICU admission (intensive care unit), and/or all-cause mortality). We evaluated both outcomes in patients whose treatment with ACEI/ARB was continued or withdrawn. Between February and June 2020, 11,205 patients were included, mean age 67 years (SD = 16.3) and 43.1% female; 2162 patients received ACEI/ARB treatment. ACEI/ARB treatment showed lower all-cause mortality (p < 0.0001). Hypertensive patients in the ACEI/ARB group had better results in IMV, ICU admission, and the composite outcome of prognosis (p < 0.0001 for all). No differences were found in the incidence of major adverse cardiovascular events. Patients previously treated with ACEI/ARB continuing treatment during hospitalization had a lower incidence of the composite outcome of prognosis than those whose treatment was withdrawn (RR 0.67, 95%CI 0.63 0.76). ARB was associated with better survival than ACEI (HR 0.77, 95%CI 0.62 0.96). ACEI/ARB treatment during COVID-19 hospitalization was associated with protection on mortality. The benefits were greater in hypertensive, those who continued treatment, and those taking ARB. 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