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Multicenter Study
. 2022 Jun;36(3):483-488.
doi: 10.1007/s10557-021-07155-5. Epub 2021 Feb 17.

Association of Antihypertensive Agents with the Risk of In-Hospital Death in Patients with Covid-19

Laurent Chouchana  1 , Nathanaël Beeker  2 , Nicolas Garcelon  3   4 , Bastien Rance  3   5 , Nicolas Paris  6 , Elisa Salamanca  6 , Elisabeth Polard  7 , Anita Burgun  3   5   8 , Jean-Marc Treluyer  9   2 , Antoine Neuraz  3   8 ; AP-HP/Universities/Inserm COVID-19 research collaboration, AP-HP Covid CDR Initiative, and “Entrepôt de Données de Santé” AP-HP Consortium”
Collaborators, Affiliations
Multicenter Study

Association of Antihypertensive Agents with the Risk of In-Hospital Death in Patients with Covid-19

Laurent Chouchana et al. Cardiovasc Drugs Ther. 2022 Jun.

Erratum in

Abstract

Purpose: The role of angiotensin receptor blockers (ARB), angiotensin-converting enzyme inhibitors (ACEi), or other antihypertensive agents in the case of Covid-19 remains controversial. We aimed to investigate the association between antihypertensive agent exposure and in-hospital mortality in patients with Covid-19.

Methods: We performed a retrospective multicenter cohort study on patients hospitalized between February 1 and May 15, 2020. All patients had been followed up for at least 30 days.

Results: Of the 8078 hospitalized patients for Covid-19, 3686 (45.6%) had hypertension and were included in the study. In this population, the median age was 75.4 (IQR, 21.5) years and 57.1% were male. Overall in-hospital 30-day mortality was 23.1%. The main antihypertensive pharmacological classes used were calcium channel blockers (CCB) (n=1624, 44.1%), beta-blockers (n=1389, 37.7%), ARB (n=1154, 31.3%), and ACEi (n=998, 27.1%). The risk of mortality was lower in CCB (aOR, 0.83 [0.70-0.99]) and beta-blockers (aOR, 0.80 [0.67-0.95]) users and non-significant in ARB (aOR, 0.88 [0.72-1.06]) and ACEi (aOR, 0.83 [0.68-1.02]) users, compared to non-users. These results remain consistent for patients receiving CCB, beta-blocker, or ARB as monotherapies.

Conclusion: This large multicenter retrospective of Covid-19 patients with hypertension found a reduced mortality among CCB and beta-blockers users, suggesting a putative protective effect. Our findings did not show any association between the use of renin-angiotensin-aldosterone system inhibitors and the risk of in-hospital death. Although they need to be confirmed in further studies, these results support the continuation of antihypertensive agents in patients with Covid-19, in line with the current guidelines.

Keywords: Calcium channel blockers; Covid-19; Drug safety; Hypertension; Renin-angiotensin-aldosterone inhibitors; SARS-CoV-2.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
In-hospital 30-day mortality in Covid-19 patients with hypertension according to antihypertensive drug exposure. These groups of users are not exclusive, and one patient can be exposed to more than one pharmacological class. Analyses have been adjusted on age, sex, and main chronic diseases (i.e., hypertension, chronic kidney disease, cerebrovascular disease, cardiovascular disease, cardiac failure, diabetes, respiratory disease, obesity, and malignancies). ARB, angiotensin II receptor blockers; ACEi, angiotensin-converting enzyme inhibitors; CCB, calcium channel blockers
See this image and copyright information in PMC

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