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: PO0845

RAAS Inhibition, Mortality, and Severity in COVID-19 Patients: A Systematic Review and Meta-Analysis

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Ali, Hatem, University Hospitals of Birmingham, Birmingham, UK, Birmingham, Birmingham, United Kingdom
  • Mohamed, Mahmoud Magdy, The University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Daoud, Ahmed, Cairo University Kasr Alainy Faculty of Medicine, Cairo, Egypt
  • Fulop, Tibor, Medical University of South Carolina, Charleston, South Carolina, United States
  • Posadas, Maria Aurora C., Medical University of South Carolina, Charleston, South Carolina, United States
  • Casey, Michael, Medical University of South Carolina, Charleston, South Carolina, United States
  • Rao, Vinaya, Medical University of South Carolina, Charleston, South Carolina, United States
  • Soliman, Karim Magdy, Medical University of South Carolina, Charleston, South Carolina, United States
Background

The effect of angiotensin-receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEi) on outcome and severity in COVID-19 patients has been postulated.

Methods

We performed a systematic review in different databases to identify studies and research work that assessed the association of ACEi/ARBs on the severity of illness and mortality in COVID-19 subjects. Inclusion criteria for our meta-analysis were all studies that included human subjects with COVID-19 infection, reported mortality and severity of the disease, and described ACEi/ARB treatment. The data collected were the name of the first author, journal title, the country of the study, sample size, relative risk and confidence intervals for association of ACEi/ARB treatment and mortality and severity. We used the random-effects model for the meta-analysis and the funnel plot analysis to assess potential publication bias.

Results

Out of 4,702 records reviewed in different databases, 11 papers were included in our meta-analysis. Altogether, 8,643 patients were included in the final analysis. Random effects model (REM) for the relationship between ACEi/ARB and survival showed that ACEi/ARB does not affect survival (relative risk [RR]=0.81, confidence interval ranges [CIR] from 0.53 to 1.23). There was no evidence of heterogeneity with I-squared =25.5% and p<0.235. By applying Egger’s test, there was no evidence of small studies effect with P=0.64. REM for the relationship between ACEi/ARB and disease severity showed that ACEi/ARB are not related to disease severity (RR=0.90, CIR from 0.70 to 1.15). There was evidence of heterogeneity with I-squared =56.2% and p=0.01. By applying Egger’s test, there was no evidence of small studies effect with P=0.93.

Conclusion

Based on the results of this meta-analysis, ACEi/ARB are not associated with increased mortality or severity in COVID-19 subjects.