Renin–Angiotensin–Aldosterone System Inhibitors and Risk of Covid-19

Renin–Angiotensin–Aldosterone System Inhibitors and Risk of Covid-19

May 1, 2020 | Harmony R. Reynolds, M.D., Samrachana Adhikari, Ph.D., Claudia Pulgarin, M.A., M.S., Andrea B. Troxel, Sc.D., Eduardo Iturrate, M.D., M.S.W., Stephen B. Johnson, Ph.D., Anaïs Hausvater, M.D., Jonathan D. Newman, M.D., M.P.H., Jeffrey S. Berger, M.D., Sripal Bangalore, M.D., Stuart D. Katz, M.D., Glenn I. Fishman, M.D., Dennis Kunichoff, M.P.H., Yu Chen, M.P.H., Ph.D., Gbenga Ogedegbe, M.D., M.P.H., and Judith S. Hochman, M.D.
This study investigates the association between the use of renin–angiotensin–aldosterone system (RAAS) inhibitors and the risk of positive Covid-19 test results and severe Covid-19 outcomes among patients tested for Covid-19. The study included 12,594 patients, of whom 5894 (46.8%) tested positive for Covid-19, and 1002 (17.0%) had severe illness. The researchers used Bayesian methods and propensity-score matching to compare outcomes in patients who had been treated with RAAS inhibitors (ACE inhibitors, angiotensin-receptor blockers, beta-blockers, calcium-channel blockers, or thiazide diuretics) and those who were untreated. They found no substantial increase in the likelihood of a positive Covid-19 test or severe Covid-19 among patients who tested positive, regardless of their medication history. Specifically, there was no significant difference in the likelihood of a positive test or severe illness with at least 97.5% certainty for all medication classes. The study concludes that the use of RAAS inhibitors does not appear to increase the risk of Covid-19 or severe Covid-19 outcomes.This study investigates the association between the use of renin–angiotensin–aldosterone system (RAAS) inhibitors and the risk of positive Covid-19 test results and severe Covid-19 outcomes among patients tested for Covid-19. The study included 12,594 patients, of whom 5894 (46.8%) tested positive for Covid-19, and 1002 (17.0%) had severe illness. The researchers used Bayesian methods and propensity-score matching to compare outcomes in patients who had been treated with RAAS inhibitors (ACE inhibitors, angiotensin-receptor blockers, beta-blockers, calcium-channel blockers, or thiazide diuretics) and those who were untreated. They found no substantial increase in the likelihood of a positive Covid-19 test or severe Covid-19 among patients who tested positive, regardless of their medication history. Specifically, there was no significant difference in the likelihood of a positive test or severe illness with at least 97.5% certainty for all medication classes. The study concludes that the use of RAAS inhibitors does not appear to increase the risk of Covid-19 or severe Covid-19 outcomes.
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