Personalized prescription of ACEI/ARBs for hypertensive COVID-19 patients

The COVID-19 pandemic has prompted an international effort to develop and repurpose medications and procedures to effectively combat the disease. Several groups have focused on the potential treatment utility of angiotensin-converting-enzyme inhibitors (ACEIs) and angiotensin-receptor blockers (ARBs...

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Main Authors: Bertsimas, D, Borenstein, A, Mingardi, L, Nohadani, O, Orfanoudaki, A, Stellato, B, Wiberg, H, Sarin, P, Varelmann, DJ, Estrada, V, Macaya, C, Gil, IJN
Format: Journal article
Language:English
Published: Springer Nature 2021
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author Bertsimas, D
Borenstein, A
Mingardi, L
Nohadani, O
Orfanoudaki, A
Stellato, B
Wiberg, H
Sarin, P
Varelmann, DJ
Estrada, V
Macaya, C
Gil, IJN
author_facet Bertsimas, D
Borenstein, A
Mingardi, L
Nohadani, O
Orfanoudaki, A
Stellato, B
Wiberg, H
Sarin, P
Varelmann, DJ
Estrada, V
Macaya, C
Gil, IJN
author_sort Bertsimas, D
collection OXFORD
description The COVID-19 pandemic has prompted an international effort to develop and repurpose medications and procedures to effectively combat the disease. Several groups have focused on the potential treatment utility of angiotensin-converting-enzyme inhibitors (ACEIs) and angiotensin-receptor blockers (ARBs) for hypertensive COVID-19 patients, with inconclusive evidence thus far. We couple electronic medical record (EMR) and registry data of 3,643 patients from Spain, Italy, Germany, Ecuador, and the US with a machine learning framework to personalize the prescription of ACEIs and ARBs to hypertensive COVID-19 patients. Our approach leverages clinical and demographic information to identify hospitalized individuals whose probability of mortality or morbidity can decrease by prescribing this class of drugs. In particular, the algorithm proposes increasing ACEI/ARBs prescriptions for patients with cardiovascular disease and decreasing prescriptions for those with low oxygen saturation at admission. We show that personalized recommendations can improve patient outcomes by 1.0% compared to the standard of care when applied to external populations. We develop an interactive interface for our algorithm, providing physicians with an actionable tool to easily assess treatment alternatives and inform clinical decisions. This work offers the first personalized recommendation system to accurately evaluate the efficacy and risks of prescribing ACEIs and ARBs to hypertensive COVID-19 patients.
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spelling oxford-uuid:6be21416-a7fc-4127-a2ef-91921f1489082024-09-06T17:35:17ZPersonalized prescription of ACEI/ARBs for hypertensive COVID-19 patientsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:6be21416-a7fc-4127-a2ef-91921f148908EnglishSymplectic ElementsSpringer Nature2021Bertsimas, DBorenstein, AMingardi, LNohadani, OOrfanoudaki, AStellato, BWiberg, HSarin, PVarelmann, DJEstrada, VMacaya, CGil, IJNThe COVID-19 pandemic has prompted an international effort to develop and repurpose medications and procedures to effectively combat the disease. Several groups have focused on the potential treatment utility of angiotensin-converting-enzyme inhibitors (ACEIs) and angiotensin-receptor blockers (ARBs) for hypertensive COVID-19 patients, with inconclusive evidence thus far. We couple electronic medical record (EMR) and registry data of 3,643 patients from Spain, Italy, Germany, Ecuador, and the US with a machine learning framework to personalize the prescription of ACEIs and ARBs to hypertensive COVID-19 patients. Our approach leverages clinical and demographic information to identify hospitalized individuals whose probability of mortality or morbidity can decrease by prescribing this class of drugs. In particular, the algorithm proposes increasing ACEI/ARBs prescriptions for patients with cardiovascular disease and decreasing prescriptions for those with low oxygen saturation at admission. We show that personalized recommendations can improve patient outcomes by 1.0% compared to the standard of care when applied to external populations. We develop an interactive interface for our algorithm, providing physicians with an actionable tool to easily assess treatment alternatives and inform clinical decisions. This work offers the first personalized recommendation system to accurately evaluate the efficacy and risks of prescribing ACEIs and ARBs to hypertensive COVID-19 patients.
spellingShingle Bertsimas, D
Borenstein, A
Mingardi, L
Nohadani, O
Orfanoudaki, A
Stellato, B
Wiberg, H
Sarin, P
Varelmann, DJ
Estrada, V
Macaya, C
Gil, IJN
Personalized prescription of ACEI/ARBs for hypertensive COVID-19 patients
title Personalized prescription of ACEI/ARBs for hypertensive COVID-19 patients
title_full Personalized prescription of ACEI/ARBs for hypertensive COVID-19 patients
title_fullStr Personalized prescription of ACEI/ARBs for hypertensive COVID-19 patients
title_full_unstemmed Personalized prescription of ACEI/ARBs for hypertensive COVID-19 patients
title_short Personalized prescription of ACEI/ARBs for hypertensive COVID-19 patients
title_sort personalized prescription of acei arbs for hypertensive covid 19 patients
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