Comparing clinical outcomes of ARB and ACEi in patients hospitalized for acute COVID-19
Abstract Continued receipt of Renin–Angiotensin–Aldosterone inhibitors in patients with COVID-19 has shown potential in producing better clinical outcomes. However, superiority between ACEi (angiotensin-converting enzyme inhibitors) and ARB (angiotensin II receptor blockers) regarding clinical outco...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2023-07-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-38838-8 |
| _version_ | 1797774234526679040 |
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| author | Seiji Hamada Tomoharu Suzuki Yasuharu Tokuda Kiyosu Taniguchi Kenji Shibuya |
| author_facet | Seiji Hamada Tomoharu Suzuki Yasuharu Tokuda Kiyosu Taniguchi Kenji Shibuya |
| author_sort | Seiji Hamada |
| collection | DOAJ |
| description | Abstract Continued receipt of Renin–Angiotensin–Aldosterone inhibitors in patients with COVID-19 has shown potential in producing better clinical outcomes. However, superiority between ACEi (angiotensin-converting enzyme inhibitors) and ARB (angiotensin II receptor blockers) regarding clinical outcomes in this setting remains unknown. We retrospectively collected data on patients hospitalized for acute COVID-19 using the nationwide administrative database (Diagnosis and Procedure Combinations, DPC). The DPC data covered around 25% of all acute care hospitals in Japan. Patient outcomes, with focus on inpatient mortality, were compared between patients previously prescribed ACEi and those prescribed ARB. Comparisons based on crude, multivariate and propensity-score adjusted analysis were conducted. We examined a total of 7613 patients (ARB group, 6903; ACEi group 710). The ARB group showed lower crude in-hospital mortality, compared to the ACEi group (5% vs 8%; odds ratio, 0.65; 95% CI 0.48–0.87), however not in the multivariate-adjusted model (odds ratio, 0.95; 95% CI 0.69–1.3) or propensity-score adjusted models (odds ratio, 0.86; 95% CI 0.63–1.2). ARB shows potential in reducing hospital stay duration over ACEi in patients admitted for COVID-19, but does not significantly reduce in-hospital mortality. Further prospective studies are needed to draw a definitive conclusion, but continuation of either of these medications is warranted to improve clinical outcomes. |
| first_indexed | 2024-03-12T22:17:04Z |
| format | Article |
| id | doaj.art-9a6a27cc003445149da635875c408ccf |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-03-12T22:17:04Z |
| publishDate | 2023-07-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-9a6a27cc003445149da635875c408ccf2023-07-23T11:14:36ZengNature PortfolioScientific Reports2045-23222023-07-011311710.1038/s41598-023-38838-8Comparing clinical outcomes of ARB and ACEi in patients hospitalized for acute COVID-19Seiji Hamada0Tomoharu Suzuki1Yasuharu Tokuda2Kiyosu Taniguchi3Kenji Shibuya4Urasoe General HospitalUrasoe General HospitalThe Tokyo Foundation for Policy ResearchNational Hospital Organization Mie National HospitalThe Tokyo Foundation for Policy ResearchAbstract Continued receipt of Renin–Angiotensin–Aldosterone inhibitors in patients with COVID-19 has shown potential in producing better clinical outcomes. However, superiority between ACEi (angiotensin-converting enzyme inhibitors) and ARB (angiotensin II receptor blockers) regarding clinical outcomes in this setting remains unknown. We retrospectively collected data on patients hospitalized for acute COVID-19 using the nationwide administrative database (Diagnosis and Procedure Combinations, DPC). The DPC data covered around 25% of all acute care hospitals in Japan. Patient outcomes, with focus on inpatient mortality, were compared between patients previously prescribed ACEi and those prescribed ARB. Comparisons based on crude, multivariate and propensity-score adjusted analysis were conducted. We examined a total of 7613 patients (ARB group, 6903; ACEi group 710). The ARB group showed lower crude in-hospital mortality, compared to the ACEi group (5% vs 8%; odds ratio, 0.65; 95% CI 0.48–0.87), however not in the multivariate-adjusted model (odds ratio, 0.95; 95% CI 0.69–1.3) or propensity-score adjusted models (odds ratio, 0.86; 95% CI 0.63–1.2). ARB shows potential in reducing hospital stay duration over ACEi in patients admitted for COVID-19, but does not significantly reduce in-hospital mortality. Further prospective studies are needed to draw a definitive conclusion, but continuation of either of these medications is warranted to improve clinical outcomes.https://doi.org/10.1038/s41598-023-38838-8 |
| spellingShingle | Seiji Hamada Tomoharu Suzuki Yasuharu Tokuda Kiyosu Taniguchi Kenji Shibuya Comparing clinical outcomes of ARB and ACEi in patients hospitalized for acute COVID-19 Scientific Reports |
| title | Comparing clinical outcomes of ARB and ACEi in patients hospitalized for acute COVID-19 |
| title_full | Comparing clinical outcomes of ARB and ACEi in patients hospitalized for acute COVID-19 |
| title_fullStr | Comparing clinical outcomes of ARB and ACEi in patients hospitalized for acute COVID-19 |
| title_full_unstemmed | Comparing clinical outcomes of ARB and ACEi in patients hospitalized for acute COVID-19 |
| title_short | Comparing clinical outcomes of ARB and ACEi in patients hospitalized for acute COVID-19 |
| title_sort | comparing clinical outcomes of arb and acei in patients hospitalized for acute covid 19 |
| url | https://doi.org/10.1038/s41598-023-38838-8 |
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