Pulmonary adverse drug event data in hypertension with implications on COVID-19 morbidity
Abstract Hypertension is a recognized comorbidity for COVID-19. The association of antihypertensive medications with outcomes in patients with hypertension is not fully described. However, angiotensin-converting enzyme 2 (ACE2), responsible for host entry of the novel coronavirus (SARS-CoV-2) leadin...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2021-06-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-021-92734-7 |
| _version_ | 1818435139921772544 |
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| author | Majid Jaberi-Douraki Emma Meyer Jim Riviere Nuwan Indika Millagaha Gedara Jessica Kawakami Gerald J. Wyckoff Xuan Xu |
| author_facet | Majid Jaberi-Douraki Emma Meyer Jim Riviere Nuwan Indika Millagaha Gedara Jessica Kawakami Gerald J. Wyckoff Xuan Xu |
| author_sort | Majid Jaberi-Douraki |
| collection | DOAJ |
| description | Abstract Hypertension is a recognized comorbidity for COVID-19. The association of antihypertensive medications with outcomes in patients with hypertension is not fully described. However, angiotensin-converting enzyme 2 (ACE2), responsible for host entry of the novel coronavirus (SARS-CoV-2) leading to COVID-19, is postulated to be upregulated in patients taking angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs). Here, we evaluated the occurrence of pulmonary adverse drug events (ADEs) in patients with hypertension receiving ACEIs/ARBs to determine if disparities exist between individual drugs within the respective classes using data from the FDA Spontaneous Reporting Systems. For this purpose, we proposed the proportional reporting ratio to provide a statistical summary for the commonality of an ADE for a specific drug as compared to the entire database for drugs in the same or other classes. In addition, a statistical procedure, multiple logistic regression analysis, was employed to correct hidden confounders when causative covariates are underreported or untrusted to correct analyses of drug-ADE combinations. To date, analyses have been focused on drug classes rather than individual drugs which may have different ADE profiles depending on the underlying diseases present. A retrospective analysis of thirteen pulmonary ADEs showed significant differences associated with quinapril and trandolapril, compared to other ACEIs and ARBs. Specifically, quinapril and trandolapril were found to have a statistically significantly higher incidence of pulmonary ADEs compared with other ACEIs as well as ARBs (P < 0.0001) for group comparison (i.e., ACEIs vs. ARBs vs. quinapril vs. trandolapril) and (P ≤ 0.0007) for pairwise comparison (i.e., ACEIs vs. quinapril, ACEIs vs. trandolapril, ARBs vs. quinapril, or ARBs vs. trandolapril). This study suggests that specific members of the ACEI antihypertensive class (quinapril and trandolapril) have a significantly higher cluster of pulmonary ADEs. |
| first_indexed | 2024-12-14T16:48:08Z |
| format | Article |
| id | doaj.art-88722c0702ca410cafac6d604c2cd4d1 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-14T16:48:08Z |
| publishDate | 2021-06-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-88722c0702ca410cafac6d604c2cd4d12022-12-21T22:54:07ZengNature PortfolioScientific Reports2045-23222021-06-011111910.1038/s41598-021-92734-7Pulmonary adverse drug event data in hypertension with implications on COVID-19 morbidityMajid Jaberi-Douraki0Emma Meyer1Jim Riviere2Nuwan Indika Millagaha Gedara3Jessica Kawakami4Gerald J. Wyckoff5Xuan Xu61DATA Consortium1DATA Consortium1DATA Consortium1DATA Consortium1DATA Consortium1DATA Consortium1DATA ConsortiumAbstract Hypertension is a recognized comorbidity for COVID-19. The association of antihypertensive medications with outcomes in patients with hypertension is not fully described. However, angiotensin-converting enzyme 2 (ACE2), responsible for host entry of the novel coronavirus (SARS-CoV-2) leading to COVID-19, is postulated to be upregulated in patients taking angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs). Here, we evaluated the occurrence of pulmonary adverse drug events (ADEs) in patients with hypertension receiving ACEIs/ARBs to determine if disparities exist between individual drugs within the respective classes using data from the FDA Spontaneous Reporting Systems. For this purpose, we proposed the proportional reporting ratio to provide a statistical summary for the commonality of an ADE for a specific drug as compared to the entire database for drugs in the same or other classes. In addition, a statistical procedure, multiple logistic regression analysis, was employed to correct hidden confounders when causative covariates are underreported or untrusted to correct analyses of drug-ADE combinations. To date, analyses have been focused on drug classes rather than individual drugs which may have different ADE profiles depending on the underlying diseases present. A retrospective analysis of thirteen pulmonary ADEs showed significant differences associated with quinapril and trandolapril, compared to other ACEIs and ARBs. Specifically, quinapril and trandolapril were found to have a statistically significantly higher incidence of pulmonary ADEs compared with other ACEIs as well as ARBs (P < 0.0001) for group comparison (i.e., ACEIs vs. ARBs vs. quinapril vs. trandolapril) and (P ≤ 0.0007) for pairwise comparison (i.e., ACEIs vs. quinapril, ACEIs vs. trandolapril, ARBs vs. quinapril, or ARBs vs. trandolapril). This study suggests that specific members of the ACEI antihypertensive class (quinapril and trandolapril) have a significantly higher cluster of pulmonary ADEs.https://doi.org/10.1038/s41598-021-92734-7 |
| spellingShingle | Majid Jaberi-Douraki Emma Meyer Jim Riviere Nuwan Indika Millagaha Gedara Jessica Kawakami Gerald J. Wyckoff Xuan Xu Pulmonary adverse drug event data in hypertension with implications on COVID-19 morbidity Scientific Reports |
| title | Pulmonary adverse drug event data in hypertension with implications on COVID-19 morbidity |
| title_full | Pulmonary adverse drug event data in hypertension with implications on COVID-19 morbidity |
| title_fullStr | Pulmonary adverse drug event data in hypertension with implications on COVID-19 morbidity |
| title_full_unstemmed | Pulmonary adverse drug event data in hypertension with implications on COVID-19 morbidity |
| title_short | Pulmonary adverse drug event data in hypertension with implications on COVID-19 morbidity |
| title_sort | pulmonary adverse drug event data in hypertension with implications on covid 19 morbidity |
| url | https://doi.org/10.1038/s41598-021-92734-7 |
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