| アブストラクト | INTRODUCTION: Renin-angiotensin system (RAS) inhibitors have been postulated to influence susceptibility to Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). This study investigated whether there is an association between their prescription and the incidence of COVID-19 and all-cause mortality. METHODS: We conducted a propensity-score matched cohort study comparing the incidence of COVID-19 among patients with hypertension prescribed angiotensin-converting enzyme I (ACE) inhibitors or angiotensin II type-1 receptor blockers (ARBs) to those treated with calcium channel blockers (CCBs) in a large UK-based primary care database (The Health Improvement Network). We estimated crude incidence rates for confirmed/suspected COVID-19 in each drug exposure group. We used Cox proportional hazards models to produce adjusted hazard ratios for COVID-19. We assessed all-cause mortality as a secondary outcome. RESULTS: The incidence rate of COVID-19 among users of ACE inhibitors and CCBs was 9.3 per 1000 person-years (83 of 18,895 users [0.44%]) and 9.5 per 1000 person-years (85 of 18,895 [0.45%]), respectively. The adjusted hazard ratio was 0.92 (95% CI 0.68 to 1.26). The incidence rate among users of ARBs was 15.8 per 1000 person-years (79 out of 10,623 users [0.74%]). The adjusted hazard ratio was 1.38 (95% CI 0.98 to 1.95). There were no significant associations between use of RAS inhibitors and all-cause mortality. CONCLUSION: Use of ACE inhibitors was not associated with the risk of COVID-19 whereas use of ARBs was associated with a statistically non-significant increase compared to the use of CCBs. However, no significant associations were observed between prescription of either ACE inhibitors or ARBs and all-cause mortality. |
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| ジャーナル名 | BMC infectious diseases |
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| 投稿日 | 2021/3/17 |
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| 投稿者 | Haroon, Shamil; Subramanian, Anuradhaa; Cooper, Jennifer; Anand, Astha; Gokhale, Krishna; Byne, Nathan; Dhalla, Samir; Acosta-Mena, Dionisio; Taverner, Thomas; Okoth, Kelvin; Wang, Jingya; Chandan, Joht Singh; Sainsbury, Christopher; Zemedikun, Dawit Tefra; Thomas, G Neil; Parekh, Dhruv; Marshall, Tom; Sapey, Elizabeth; Adderley, Nicola J; Nirantharakumar, Krishnarajah |
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| 組織名 | Institute of Applied Health Research, University of Birmingham, Birmingham, UK.;Cegedim Health Data, Cegedim Rx, London, UK.;The Health Improvement Network (THIN), London, UK.;Department of Diabetes, Gartnavel General Hospital, NHS Greater Glasgow and;Clyde, Glasglow, UK.;Birmingham Acute Care Research Group, Institute of Inflammation and Ageing,;University of Birmingham, Birmingham, UK.;Department of Acute Medicine, Queen Elizabeth Hospital Birmingham, Birmingham,;UK.;PIONEER, The Health Data Research UK Hub in Acute Care, Birmingham, UK.;N.J.Adderley@bham.ac.uk.;Department of Diabetes and Endocrinology, University Hospitals Birmingham NHS;Foundation Trust, Birmingham, UK.;Midlands Health Data Research UK, Birmingham, UK. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/33722197/ |
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