Renin–Angiotensin–Aldosterone System Inhibitors and Risk of Covid-19

Type Journal Article Author Harmony R. Reynolds Author Samrachana Adhikari Author Claudia Pulgarin Author Andrea B. Troxel Author Eduardo Iturrate Author Stephen B. Johnson Author Anaïs Hausvater Author Jonathan D. Newman Author Jeffrey S. Berger Author Sripal Bangalore Author Stuart D. Katz Author Glenn I. Fishman Author Dennis Kunichoff Author Yu Chen Author Gbenga Ogedegbe Author Judith S. Hochman URL https://www.nejm.org/doi/10.1056/NEJMoa2008975 Rights Copyright © 2020 Massachusetts Medical Society. All rights reserved. Volume N Engl J Med 2020; 382:2441-2448 Publication New England Journal of Medicine Date 01/05/2020 Loc. in Archive world Extra Publisher: Massachusetts Medical Society DOI 10.1056/NEJMoa2008975 Accessed 2020-06-27 13:45:35 Library Catalog www.nejm.org Language en Abstract Background There is concern about the potential of an increased risk related to medications that act on the renin–angiotensin–aldosterone system in patients exposed to coronavirus disease 2019 (Covid-19), because the viral receptor is angiotensin-converting enzyme 2 (ACE2). Methods We assessed the relation between previous treatment with ACE inhibitors, angiotensin-receptor blockers, beta-blockers, calcium-channel blockers, or thiazide diuretics and the likelihood of a positive or negative result on Covid-19 testing as well as the likelihood of severe illness (defined as intensive care, mechanical ventilation, or death) among patients who tested positive. Using Bayesian methods, we compared outcomes in patients who had been treated with these medications and in untreated patients, overall and in those with hypertension, after propensity-score matching for receipt of each medication class. A difference of at least 10 percentage points was prespecified as a substantial difference.