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Hadadi A, Kazemian S, Shafie M, Ahmadi A, Soleimani A, Ashraf H. Effects of angiotensin receptor blockers (ARBs) on clinical outcomes of patients with hypertension and COVID-19: A 7-month follow-up cohort study. J Cardiovasc Thorac Res 2022; 14:253-257. [PMID: 36699557 PMCID: PMC9871165 DOI: 10.34172/jcvtr.2022.30559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 10/02/2022] [Indexed: 01/09/2023] Open
Abstract
Introduction: Since the coronavirus disease 2019 (COVID-19) pandemic, the use of angiotensin II receptor blockers (ARBs) in hypertensive patients with COVID-19 has been controversial. Following our previous study, after one year, we intended to extend our sample size and results to investigate the effects of ARBs with both in-hospital outcomes and 7-month follow-up results in patients with COVID-19. Methods: Patients with a diagnosis of COVID-19 who were admitted to Sina Hospital, Tehran, Iran, from February to October 2020 participated in this follow-up cohort study. The COVID-19 diagnosis was based on a positive polymerase chain reaction test or chest computed tomography scan according to guidelines. Patients were followed for disease severity, incurring in-hospital mortality, complications, and 7-month all-cause mortality. Results: We evaluated 1413 patients with COVID-19 in this study. After excluding 124 patients, 1289 including 561(43.5%) hypertensive patients, entered the analysis. During the study, 875(67.9%) severe disease, 227(17.6%) in-hospital mortality, and 307(23.8%) 7-month all-cause mortality were observed. After adjusting for possible confounders, ARB was not associated with severity, in-hospital and 7-month all-cause mortality, and in-hospital complications except for acute kidney injury. Discontinuation of ARBs was significantly associated with higher in-hospital mortality and 7-month all-cause mortality (both P values<0.006). We observed a better 7-month outcome in those who continued their ARBs after discharge. Conclusion: The results of this study, along with the previous studies, provide reassurance that taking ARBs is not associated with the risk of mortality, complications, and poorer outcomes in hypertensive COVID-19 patients after adjustment for possible confounders.
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Affiliation(s)
- Azar Hadadi
- Research Center for Clinical Virology, Tehran University of Medical Sciences, Tehran, Iran,Contributed equally to this study as co-first authors
| | - Sina Kazemian
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran,Contributed equally to this study as co-first authors
| | - Mahan Shafie
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran,NeuroTRACT Association, Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Arezoo Ahmadi
- Department of Anesthesiology and Critical Care, Sina Hospital, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Soleimani
- Department of Cardiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Haleh Ashraf
- Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran,Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran,Corresponding Author: Haleh Ashraf,
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