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Observational Study
. 2021 Mar;36(Suppl 1):S114-S122.
doi: 10.3904/kjim.2020.380. Epub 2021 Feb 25.

Update on association between exposure to renin-angiotensin-aldosterone system inhibitors and coronavirus disease 2019 in South Korea

Jeongkuk Seo  1 , Minkook Son  2
Affiliations
Observational Study

Update on association between exposure to renin-angiotensin-aldosterone system inhibitors and coronavirus disease 2019 in South Korea

Jeongkuk Seo et al. Korean J Intern Med. 2021 Mar.

Abstract

Background/aims: Since the onset of the coronavirus disease 2019 (COVID-19) pandemic, there have been concerns about the association between exposure to renin-angiotensin-aldosterone system (RAAS) inhibitors and the risk and severity of COVID-19.

Methods: We performed a case-control study that utilized up-to-date data on the South Korean population provided by the Korean National Health Insurance System. Of the 62,909 patients with hypertension or heart failure tested for COVID-19, there were 1,644 (2.6%) confirmed cases. After case-control matching, multivariable-adjusted conditional logistic regression analysis was performed.

Results: Comparison between patients exposed to RAAS inhibitors and those not exposed to RAAS inhibitors revealed that the adjusted odds ratio (OR) and 95% confidence interval (CI) for COVID-19 infection and death were 0.981 (95% CI, 0.849 to 1.135) and 0.875 (95% CI, 0.548 to 1.396), respectively. Subgroup analysis for the major confounders, age and region of diagnosis, resulted in OR of 0.912 (95% CI, 0.751 to 1.108) and 0.942 (95% CI, 0.791 to 1.121), respectively.

Conclusion: The present study demonstrated no evidence of association between RAAS inhibitor exposure and risk and severity of COVID-19.

Keywords: COVID-19; Heart failure; Hypertension; Renin-angiotensin system; Republic of Korea.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1.
Figure 1.
Flow of study subjects. COVID-19, coronavirus disease 2019.
See this image and copyright information in PMC

References

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