24 September 2020: Clinical Research
A Retrospective Study from 2 Centers in China on the Effects of Continued Use of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers in Patients with Hypertension and COVID-19
Zhongchao Wang 1ABCDEFG* , Dewei Zhang 2BC* , Shengming Wang 3BC* , Yanhua Jin 2BC* , Jianbo Huan 4BC* , Yue Wu 5CDF* , Cheng Xia 2CD , Zhe Li 6B , Xingshun Qi 7CF , Duanzhen Zhang 8DF , Xiumin Han 8DF , Xianyang Zhu 8DEF , Ying Qu 9ABCDEFG* , Qiguang Wang 8ACDEFG*DOI: 10.12659/MSM.926651
Med Sci Monit 2020; 26:e926651
Table 3 Clinical outcomes and adverse events of all included COVID-19 patients complicated with hypertension.
| Parameters | Overall (n=210) | ACEIs/ARBs (n=81) | Non-ACEIs/ARBs (n=129) | P value |
|---|---|---|---|---|
| Clinical outcomes | ||||
| Death during hospitalization, n (%) | 12 (5.71) | 7 (8.64) | 5 (3.88) | 0.148 |
| 7-categorical ordinal scale at discharge | ||||
| ≤2, n (%) | 190 (90.48) | 69 (85.19) | 121 (93.80) | 0.038 |
| 1 | 159 (75.71) | 56 (69.14) | 103 (79.84) | 0.078 |
| 2 | 31 (14.76) | 13 (16.05) | 18 (13.95) | 0.677 |
| >2, n (%) | 20 (9.52) | 12 (14.81) | 8 (6.20) | 0.038 |
| 3 | 3 (1.43) | 1 (1.23) | 2 (1.55) | 1.000 |
| 4 | 4 (1.90) | 3 (3.70) | 1 (0.78) | 0.321 |
| 5 | 1 (0.48) | 1 (1.23) | 0 (0) | 0.814 |
| 6 | 0 (0) | 0 (0) | 0 (0) | |
| 7 | 12 (5.71) | 7 (8.64) | 5 (3.88) | 0.148 |
| Days of hospital stay, median (IQR) | 17.00 (13.00–21.00) | 17.00 (13.00–21.00) | 17.00 (13.00–21.00) | 0.820 |
| Number of ICU stay cases during hospitalization, n (%) | 16 (7.62) | 10 (12.35) | 6 (4.65) | 0.041 |
| Ratio of ICU days during hospitalization (%), median (IQR) | 73.86 (53.64–100.00) | 72.08 (54.24–100.00) | 87.50 (42.62–100.00) | 0.781 |
| Number of cases with symptom relief, n (%) | 180 (85.71) | 71 (87.65) | 109 (84.50) | 0.524 |
| Ratio of days from treatment initiation to symptom relief (%), median (IQR) | 38.80 (17.85–66.67) | 36.36 (19.23–77.78) | 41.67 (14.64–62.50) | 0.628 |
| Number of cases with SARS-CoV-2 nuclei acid testing turning negative, n (%) | 203 (96.67) | 77 (95.06) | 126 (97.67) | 0.528 |
| Ratio of days from treatment initiation to first negative SARS-CoV-2 nuclei acid testing (%), median (IQR) | 30.00 (15.38–47.06) | 30.00 (14.84–47.14) | 29.29 (15.38–47.20) | 0.795 |
| Number of cases with CT-shown absorption of pulmonary infection, n (%) | 198 (94.29) | 75 (92.59) | 123 (95.35) | 0.402 |
| Ratio of days from treatment initiation to definite CT-shown absorption of pulmonary infection (%), median (IQR) | 69.78 (53.62–82.61) | 63.64 (45.00–78.57) | 75.00 (58.33–84.62) | 0.004 |
| Ratio of days of BP above normal range (%), median (IQR) | 41.67 (16.50–67.11) | 46.15 (27.89–76.70) | 38.46 (13.96–61.39) | 0.012 |
| BP values above normal range | ||||
| mSBP (mmHg), median (IQR) | 5.79 (1.00–11.38) | 7.00 (3.00–11.72) | 5.00 (0.00–10.85) | 0.025 |
| mDBP (mmHg), median (IQR) | 1.00 (0.00–5.00) | 3.00 (0.00–5.75) | 1.00 (0.00–4.58) | 0.201 |
| eSBP (mmHg), median (IQR) | 7.08 (3.00–11.75) | 8.79 (4.00–13.12) | 6.00 (1.25–10.88) | 0.003 |
| eDBP (mmHg), median (IQR) | 3.00 (0.00–6.50) | 3.00 (0.00–7.04) | 3.00 (0.00–6.50) | 0.697 |
| Adverse events, n (%) | 11 (5.24) | 5 (6.17) | 6 (4.65) | 0.630 |
| General | 3 (1.43) | 0 (0) | 63 (2.33) | 0.432 |
| Digestive system | 4 (1.91) | 2 (2.47) | 2 (1.55) | 1.000 |
| Nervous system | 2 (0.95) | 2 (2.47) | 0 (0) | 0.288 |
| Respiratory system | 2 (0.95) | 1 (1.23) | 1 (0.77) | 1.000 |
| ACEIs – angiotensin-converting enzyme inhibitors; ARBs – angiotensin II receptor blockers; IQR – interquartile range; SARS-CoV-2 – severe acute respiratory syndrome coronavirus 2; CCBs – calcium channel blockers; ICU – Intensive Care Unit; m/eSBP – morning/evening systolic pressure; m/eDBP – morning/evening diastolic pressure. | ||||