No harm from angiotensin-converting enzyme inhibitors or angiotensin receptor inhibitors in patients with COVID-19. Results of a prospective study on a hospital-based cohort

• Main Authors: Gian Paolo Anzola, Clara Bartolaminelli, Gina Alessandra Gregorini, Chiara Coazzoli, Francesca Gatti, Alessandra Mora, Dimitrios Charalampakis, Andrea Palmigiano, Michele De Simone, Alice Comini, Erica Dellaglio, Salvatore Cassetti, Maurizio Chiesa, Francesca Spedini, Patrizia d'Ottavi, Maria Cristina Savio
• Format: Article
• Language: English
• Published: PAGEPress Publications 2020-09-01
• Series: Italian Journal of Medicine
• Subjects: COVID-19; angiotensin-converting enzyme inhibitors; angiotensin receptor inhibitors.
• Online Access: https://italjmed.org/index.php/ijm/article/view/1313
• ISSN: 1877-9344; 1877-9352

This study aims to assess the effect of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor inhibitors (ARBs) on the course of COVID-19. It is a prospective study on 221 (M/F ratio= 143/78, mean age 72±13) consecutive hypertensive patients with COVID-19: 76 (34.4%) treated with ACEIs, 63 (28.5%) with ARBs and 82 (37.1%) with antihypertensives OTHER than ACEIs or ARBs. They were all followed up until discharge or death. BAD outcome was defined as the need for invasive mechanical ventilation or death. The three classes of medication were well balanced for confounding variables. BAD outcome was overall recorded in 63/221 (28%) patients, in 20/76 (26%) of ACEI, in 17/63 (27%) of ARB and in 26/82 (32%) of OTHER users, with no statistically significant difference in any comparison. These findings refute the hypothesis that treatment with ACEIs or ARBs may negatively affect the course of COVID-19.