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. 2024 Jun;32(3):1805-1815.
doi: 10.1007/s10787-024-01475-2. Epub 2024 Apr 15.

Impact of prior antihypertensive treatment on COVID-19 outcomes, by active ingredient

Rosa María García-Álvarez  1   2 , Maruxa Zapata-Cachafeiro  3   4   5 , Irene Visos-Varela  2 , Almudena Rodríguez-Fernández  2   6   7 , Samuel Pintos-Rodríguez  2 , Maria Piñeiro-Lamas  7 , Teresa M Herdeiro  8 , Adolfo Figueiras  2   6   7 , Angel Salgado-Barreira  2   6   7 ; COVID-Drug Group
Collaborators, Affiliations

Impact of prior antihypertensive treatment on COVID-19 outcomes, by active ingredient

Rosa María García-Álvarez et al. Inflammopharmacology. 2024 Jun.

Abstract

Objectives: To assess the impact of prior chronic treatment with angiotensin-converting enzyme inhibitors (ACEIs)/ angiotensin-receptor blockers (ARBs), both as a group and by active ingredient, on severity (risk of hospitalization and mortality), progression of and susceptibility to COVID-19.

Methods: We conducted a multiple population-based case-control study in Galicia (north-west Spain). The study data were sourced from medical, administrative and clinical databases. We assessed: (1) risk of hospitalization, by selecting all patients hospitalized due to COVID-19 with PCR + as cases, and a random sample of subjects without a PCR + as controls; (2) COVID-19 mortality risk; (3) risk of disease progression; and (4) susceptibility to SARS-CoV-2, considering all patients with PCR + as cases, and the same subjects used in the previous model as controls. Adjusted odds ratios (aORs) were calculated.

Results: ACEIs and ARBs were shown to decrease the risk of hospitalization (aOR = 0.78 [95%CI 0.69-0.89] and aOR = 0.80 [95%CI 0.72-0.90] respectively), risk of mortality (aOR = 0.71 [95%CI 0.52-0.98] and aOR = 0.69 [95%CI 0.52-0.91] respectively), and susceptibility to the virus (aOR = 0.88 [95%CI 0.82-0.94] and aOR = 0.92 [95%CI 0.86-0.97] respectively). By active ingredient: use of enalapril was associated with a significantly lower risk of hospitalization (aOR = 0.72 [95%CI 0.61-0.85]), mortality (aOR = 0.59 [95%CI 0.38-0.92]) and susceptibility to COVID-19 (aOR = 0.86 [95%CI 0.79-0.94]); and use of candesartan was associated with a decreased risk of hospitalization (aOR = 0.76 [95%CI 0.60-0.95]), mortality (aOR = 0.36 [95%CI 0.17-0.75]) and disease progression (aOR = 0.73 [95%CI 0.56-0.95]).

Conclusion: This large-scale real-world data study suggest that enalapril and candesartan are associated with a considerable reduction in risk of severe COVID19 outcomes.

Keywords: COVID-19; Candesartan; Enalapril; Hospitalization; Mortality.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Fig 1
Fig 1
Population-based multiple case-control design
See this image and copyright information in PMC

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