Relationship between angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin-receptor blockers (ARBs) use with outcome and cardiovascular involvement in patients with COVID-19

Abstract

Background

 The COVID-19 used the Angiotensin-converting enzyme 2 (ACE2) receptors to cells entry. ACE inhibitors (ACEI) and angiotensin II receptor type 2 blockers (ARBs) are one of the medications used in COVID-19 patients. Some studies suggested that both of them may increase virulence of COVID-19.

Objectives

The aim of the study was to determine whether clinical condition of ACEIs/ARBs users are significantly different from non-ACEIs/ARBs users or not.

Methods

 In this cross-sectional study, 671 patients who were recognized by RT-PCR participated in the study. ACEIs/ARBs users in these positive participants were 175 (26%). All of them had been using ACEs/ARBs before got COVID-19. Demographic, clinical, and paraclinical data were collected through medical records and laboratory results.

Results

Our analysis demonstrated both groups did not different significantly in term of death (p value=0.12). Prevalence of severe clinical course was significantly higher than non-ACEIs/ARBs users. However, we matched both groups in terms of gender and age. Surprisingly, it represented ACEIs/ARBs users had not more chance to experience a severe clinical course [p=0.35, OR=1.22, CI (0.79, 1.87)]. Moreover, the mean of ejection fraction (EF) was higher in them (51.6 ± 8.3, p<0.001). Also, frequency of CRP positive patients was more in them (73.1%, p=0.09). Other laboratory results (leukocytes and lymphocytes counts, LDH) were not significant.

Conclusions

There was not enough evidence to show ACEI and ARBs drugs could be a risk factor for severity of COVID19. Thus, their treatment regime should not alter for COVID-19.