Efficacy of ACEIs/ARBs versus CCBs on the progression of COVID-19 patients with hypertension in Wuhan: A hospital-based retrospective cohort study

J Med Virol. 2020 Jul 20. doi: 10.1002/jmv.26315. Online ahead of print.

Abstract

Background: To evaluate the efficacy of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) versus calcium channel blockers (CCBs) on the progression of COVID-19 patients with hypertension in Wuhan.

Methods: This retrospective single-center case series analyzed COVID-19 patients with hypertension, treated with ACEIs/ACEIs or CCBs at the Tongji Hospital of Wuhan City, Chin from January 25th to March 15th, 2020. After PSM analysis, 76 patients were selected into two groups. Univariate and multivariable analyses were conducted to determine factors related to improvement measures and outcome measures by Cox proportional hazard regression models.

Results: Among 157 patients with confirmed COVID-19 combined hypertension, including 73 males and 84 females, a median age of 67.28 ±9.11 vs 65.39 ±10.85 years. A univariable analysis indicated that clinical classification, lymphp cyte count and interleukin-2 receptor were associated with a lengthened negative time of nucleic acid, with a significant difference between two groups (p=0.036). Furthermore, we found no obvious difference in nucleic acid conversion time between ACEIs/ARBs group and CCBs group (HR 0.70, 95% CI [0.97, 3.38], p=0.18) in the multivariable analysis as well as chest CT improved time (HR 0.73, 95% CI [0.45, 1.2], p=0.87), and hospitalization time between ACEIs/ARBs group and CCBs group (HR 1.06, 95% CI [0.44, 1.1], p=0.83).

Conclusion: Our study provided additional evidence of no obvious difference in progress and prognosis between ACEIs/ACEIs and CCBs group, which may suggest ACEIs/ARBs may have scarcely influence on increasing the clinical severe situations of COVID-19 patients with hypertension. This article is protected by copyright. All rights reserved.

Keywords: ACEIs; ARBs; CCBs; COVID-19; RAS blockers; hypertension.