ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: PO0850

Outcomes Associated with the Use of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers in Hospitalized Patients with SARS-CoV-2 Infection

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Chaudhri, Imran, Stony Brook University Hospital, Stony Brook, New York, United States
  • Koraishy, Farrukh M., Stony Brook University Hospital, Stony Brook, New York, United States
  • Bolotova, Olena, Stony Brook University Hospital, Stony Brook, New York, United States
  • Yoo, Jeanwoo, Stony Brook University Hospital, Stony Brook, New York, United States
  • Mallipattu, Sandeep K., Stony Brook University Hospital, Stony Brook, New York, United States
Background

SARS-CoV-2 uses the angiotensin converting enzyme (ACE) receptor for cell entry leading to COVID-19. The use of ACE Inhibitors (ACEIs) and Angiotensin II Receptor Blockers (ARBs) in hypertensive COVID-19 patients remains unclear. Since hypertension is a major comorbidity in COVID19, evaluating the efficacy versus adverse outcomes with the use of ACEI or ARB in patients with COVID-19 is essential.

Methods

In this retrospective single-center study, we analyzed electronic medical record data on 300 patients admitted with COVID-19 disease. Data collection included comorbidities, medications, vital signs, and laboratory values (on admission and during hospitalization). Outcomes included inflammatory burden (calculated using composite scores for multiple markers of inflammation), AKI, admission to the intensive care unit (ICU), need for mechanical ventilation, and mortality. For multivariate analyses, generalized linear model (continuous outcomes) and logistic regression (dichotomous outcomes) were used.

Results

Of the 300 patients, 80 patients (26.7%) had history of ACEI or ARB use prior to admission, with 61.3% (49/80) of these patients continuing the medications during hospitalization. Outpatient users of ACEI or ARB had a higher burden of comorbid disease and increased rates of admission and in-hospital AKI in the descriptive analysis, but not on multivariate analysis (after adjusting for multiple covariates). Continuation of ACEI or ARB inpatient was associated with lower peak C-reactive protein (CRP) levels, peak inflammation score, ICU admission and mortality in the univariate analysis. On multivariate analysis, continuation of these agents during hospitalization predicted lower ICU admissions (OR=0.25, 0.08-0.81, p=0.02), peak CRP (-6.9 ± 3.1 mg/dl, p=0.03) and peak inflammatory score (-2.3 ± 1.1, p=0.04) as compared to their discontinuation.

Conclusion

In hospitalized patients with COVID-19, the use of ACEI or ARBs as an outpatient was not associated with adverse outcomes despite greater comorbid illness in users. The continued use of these medications during hospitalization was also not associated with adverse events, rather it predicted fewer ICU admissions and decreased inflammatory burden.

Funding

  • NIDDK Support